465 results match your criteria: "Royal Perth Hospital Unit.[Affiliation]"

Conference on 'Sustainable nutrition for a healthy life'.

Proc Nutr Soc

December 2023

Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.

Nutrition scientists are currently facing a substantial challenge: to feed the world population sustainably and ethically while supporting the health of all individuals, animals and the environment. The Nutrition Society of Australia's 2022 Annual Scientific meeting theme 'Sustainable nutrition for a healthy life' was a timely conference focusing on the environmental impact of global, national and local food systems, how nutrition science can promote sustainable eating practices while respecting cultural and culinary diversity and how to ensure optimal nutrition throughout life to prevent and manage chronic diseases. Comprehensive, diverse, collaborative and forward-thinking research was presented in a 3 d programme of keynote presentations, oral and poster sessions, breakfast and lunch symposiums, ending with a panel discussion to answer the question of how we can best achieve a nutritious food supply that supports human and planetary health.

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Background: Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.

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The relationship between long-term blood pressure variability and cortical thickness in older adults.

Neurobiol Aging

September 2023

Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia.

High blood pressure variability (BPV) is a risk factor for cognitive decline and dementia, but its association with cortical thickness is not well understood. Here we use a topographical approach, to assess links between long-term BPV and cortical thickness in 478 (54% men at baseline) community dwelling older adults (70-88 years) from the ASPirin in Reducing Events in the Elderly NEURO sub-study. BPV was measured as average real variability, based on annual visits across three years.

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Background: The Global SYMPLICITY Registry DEFINE (Denervation Findings in Real World) investigates radiofrequency renal denervation (RDN) in a broad range of patients with hypertension. We evaluated whether the number or type of antihypertensive medications were associated with increased long-term blood pressure (BP) reductions and cardiovascular outcomes following radiofrequency RDN.

Methods: Patients underwent radiofrequency RDN and were categorized by baseline number (0-3 and ≥4) and different combinations of medication classes.

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Study Objective: This study examined the association between frailty and incident cardiovascular disease (CVD) events, major adverse cardiovascular events (MACE), and CVD-related mortality.

Design: Longitudinal cohort study.

Setting: The ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial in Australia and the United States.

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Efficacy and safety of sodium glucose cotransporter 2 inhibitors plus standard care in diabetic kidney disease: A systematic review and meta-analysis.

J Diabetes Complications

June 2023

Medical School, The University of Western Australia, Perth, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.

Introduction: Many people with type 2 diabetes progress to end-stage diabetic kidney disease (DKD) despite blockade of the renin-angiotensin system, suggesting the need for innovative treatment options for DKD. To capture the findings of recent studies, we performed an updated systematic review and meta-analysis of the efficacy and safety of sodium glucose co-transporter 2 (SGLT2) inhibitors combined with standard care involving angiotensin converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs) on the development and progression of DKD in people with type 2 diabetes compared with standard care alone.

Methods: The Cochrane Library, MEDLINE, EMBASE, PubMed and clinical trials registers were systematically searched for randomized controlled trials published before 1 September 2022.

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Background: Diabetic retinopathy (DR) is a leading cause of end-stage blindness globally and is arguably one of the most disabling complications of both Type 1 and Type 2 diabetes. Sodium Glucose Cotransporter-2 (SGLT2) inhibitors have now been successfully introduced to clinical medicine and exert multiple beneficial effects in diabetic patients. Given the broad therapeutic application of SGLT2 inhibitors, we hypothesised that SGLT2 inhibition may alleviate the progression of DR.

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Multi-organ denervation: a novel approach to combat cardiometabolic disease.

Hypertens Res

July 2023

Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, WA, Australia.

Cardiometabolic disorders are associated with a substantial loss in quality of life and pose a large burden on healthcare systems worldwide. Overactivation of the sympathetic nervous system has been shown to be a key player in several aspects relating to cardiometabolic disturbances. While diet- and exercise-induced approaches to help reduce weight remains the main strategy to combat metabolic disorders, this is often difficult to achieve.

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The Adrenal Vein Sampling Outcomes Study (AVOS): success rates following adrenalectomy for unilateral primary aldosteronism.

Pathology

June 2023

Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, WA, Australia; Medical School, University of Western Australia, Perth, WA, Australia; Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, WA, Australia. Electronic address:

The objective was to determine the clinical and biochemical success rates and assess the nature of follow-up after adrenalectomy in patients with unilateral primary aldosteronism (PA), subtyped by adrenal vein sampling (AVS) in West Australia (WA) using the Primary Aldosteronism Surgical Outcome (PASO) criteria. Clinical and biochemical outcomes were retrospectively evaluated in patients with unilateral PA who underwent adrenalectomy according to AVS between September 2017 and September 2020. Pre- and post-surgical data were collected using a standardised questionnaire, review of clinic letters and examination of private and public pathology results and radiological reports.

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In a first of its kind assessment in cardiovascular research, we assessed whether pooled cardiovascular expertise could accurately predict efficacy and tolerability for both a novel and an established treatment option. A survey was administered prior to the publication of the QUARTET (A Quadruple UltrA-low-dose tReatment for hypErTension) trial. QUARTET was a multicentre, double-blind, parallel-group, trial that randomised participants to initial treatment with either monotherapy or an ultra-low dose quadruple single pill combination for 12 weeks.

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Objectives: Cuffless wearable blood pressure (BP) devices may allow detailed evaluation of BP for prolonged periods, but their ability to accurately track BP changes is uncertain. We investigated whether a commercially available cuffless wearable device tracks: 24-h systolic (SBP) and diastolic BP (DBP) compared to conventional ambulatory monitoring (ABPM); and antihypertensive medication-induced BP changes compared to cuff-based home BP monitoring (HBPM).

Methods: We fitted 41 participants (32% females, 58 ± 14 years, 80% hypertensive) with a wrist-wearable cuffless BP device (Aktiia) continuously for 6-12 days.

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The Sympathetic Nervous System Regulates Sodium Glucose Co-Transporter 1 Expression in the Kidney.

Biomedicines

March 2023

Dobney Hypertension Centre, School of Biomedical Science-Royal Perth Hospital Unit, Royal Perth Hospital Research Foundation, University of Western Australia, Crawley, WA 6009, Australia.

Hyperactivation of the sympathetic nervous system (SNS) has been demonstrated in various conditions including obesity, hypertension and type 2 diabetes. Elevated levels of the major neurotransmitter of the SNS, norepinephrine (NE), is a cardinal feature of these conditions. Increased levels of the sodium glucose cotransporter 1 (SGLT1) protein have been shown to occur in the parotid and submandibular glands of hypertensive rodents compared to normotensive controls.

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Since the publication of the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Management of Arterial Hypertension, several high-quality studies, including randomised, sham-controlled trials on catheter-based renal denervation (RDN) were published, confirming both the blood pressure (BP)-lowering efficacy and safety of radiofrequency and ultrasound RDN in a broad range of patients with hypertension, including resistant hypertension. A clinical consensus document by the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on RDN in the management of hypertension was considered necessary to inform clinical practice. This expert group proposes that RDN is an adjunct treatment option in uncontrolled resistant hypertension, confirmed by ambulatory BP measurements, despite best efforts at lifestyle and pharmacological interventions.

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Since the publication of the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Management of Arterial Hypertension, several high-quality studies, including randomised, sham-controlled trials on catheter-based renal denervation (RDN) were published, confirming both the blood pressure (BP)-lowering efficacy and safety of radiofrequency and ultrasound RDN in a broad range of patients with hypertension, including resistant hypertension. A clinical consensus document by the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on RDN in the management of hypertension was considered necessary to inform clinical practice. This expert group proposes that RDN is an adjunct treatment option in uncontrolled resistant hypertension, confirmed by ambulatory BP measurements, despite best efforts at lifestyle and pharmacological interventions.

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Catheter-Based Renal Denervation: 9-Year Follow-Up Data on Safety and Blood Pressure Reduction in Patients With Resistant Hypertension.

Hypertension

April 2023

Human Neurotransmitter and Neurovascular Hypertension and Kidney Diseases Laboratories (G.S.-A., R.L., Y.S., M.D.E., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, Australia.

Background: Recent sham-controlled randomized clinical trials have confirmed the safety and efficacy of catheter-based renal denervation (RDN). Long-term safety and efficacy data beyond 3 years are scarce. Here, we report on outcomes after RDN in a cohort of patients with resistant hypertension with an average of ≈9-year follow-up (FU).

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Article Synopsis
  • Raised blood pressure (BP) is a significant risk factor for cardiovascular issues and mortality, with a global campaign called May Measurement Month launched to raise awareness and encourage BP screenings since 2017 in Australia.
  • Over three years, about 10,046 adults were screened, revealing that 31% had hypertension, with only 48.5% being aware of their condition and 44.4% actively taking medication.
  • The findings highlighted a concerning lack of awareness and poor control of hypertension in Australia, which are below global averages, indicating the need for collective action to improve treatment and management rates.
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Time in Target Range: the Future of Assessing Adequacy of Blood Pressure Control?

Hypertension

February 2023

Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Australia; Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Australia; and Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.

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Determining the Role of SGLT2 Inhibition with Dapagliflozin in the Development of Diabetic Retinopathy.

Front Biosci (Landmark Ed)

December 2022

Dobney Hypertension Centre, School of Biomedical Science - Royal Perth Hospital Unit, University of Western Australia, 6009 Crawley, WA, Australia.

Article Synopsis
  • - The study investigates the effects of Dapagliflozin (DAPA), an SGLT2 inhibitor, on diabetic retinopathy (DR) in mice, highlighting its potential benefits for eye health in diabetes.
  • - Treatment with DAPA for 8 weeks showed metabolic improvements in mice, such as better glucose tolerance and reduced retinal damage, alongside increased levels of a beneficial growth factor, FGF21.
  • - Results suggest that inhibiting SGLT2 could be a promising new therapeutic approach for preventing retinal damage in diabetic patients, indicating the role of SGLT1 in this process as well.
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Evaluation of Circulating Platelet Extracellular Vesicles and Hypertension Mediated Organ Damage.

Int J Mol Sci

December 2022

Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit, Royal Perth Hospital Medical Research Foundation, The University of Western Australia, Perth, WA 6000, Australia.

Elevated circulating platelet-derived extracellular vesicles (pEVs) have been associated with arterial hypertension. The role of hypertension-mediated organ damage (HMOD) to induce EV release is still unknown. We studied the micro- and macro-vascular changes (retinal vascular density and pulse wave velocity), endothelial function (flow-mediated vasodilation of brachial artery and finger plethysmography), and assessed the psychosocial status (anxiety and depression) in hypertensive patients to determine their relationship with EV release.

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COVID-19 vaccination-related exacerbation of seizures in persons with epilepsy.

Epilepsy Behav

January 2023

Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Discipline of Internal Medicine, Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia.

Although vaccines are generally safe in persons with epilepsy (PWE), seizures can be associated with vaccination, including COVID-19. This study assessed the occurrence of COVID-19 vaccination-related seizure exacerbations in PWE. Adult PWE who had received a COVID-19 vaccine were consecutively recruited at a tertiary epilepsy clinic between June 2021 and April 2022.

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Evolving Role of Catheter Ablation for Atrial Fibrillation: Early and Effective Rhythm Control.

J Clin Med

November 2022

Cardioangiologisches Centrum Bethanien (CCB), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, 60431 Frankfurt am Main, Germany.

Article Synopsis
  • Catheter Ablation (CA) is an effective treatment for atrial fibrillation (AF), significantly reducing symptoms and improving clinical outcomes.
  • Early intervention in AF is crucial, as starting rhythm control sooner is linked to better cardiovascular health and reduced hospital readmissions.
  • Although CA shows limited success in persistent AF cases, patients with early persistent AF tend to have better outcomes, and new ablation techniques may enhance treatment effectiveness.
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Background: Although a healthy diet and physical activity have been shown to prevent or delay cardiovascular disease (CVD) hospitalizations and deaths, most adults do not meet current guidelines. Provision of coronary artery calcification (CAC) and carotid ultrasound (CUS) imaging results may motivate beneficial lifestyle changes. We scoped the existing literature for studies providing non-invasive vascular imaging results and reporting diet, physical activity, and/or anthropometric measures to identify knowledge gaps and opportunities for further research.

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