Project leader: Geoff Head (collaborative project with Chris Reid)
There is an urgent need for a better understanding of the use of measures of ambulatory blood pressure recording in absolute risk assessment, initiating treatment, and altering therapy in established hypertensive patients. Subjects with a large morning blood pressure surge have been shown to have a higher risk of stroke, independent of other risk factors. However, methods for determining these parameters are limited. We have developed a novel method for determining the rate and the 'power' of rise of morning blood pressure using standard ambulatory blood pressure (ABP) recordings. The morning power is calculated as the rate of rise times the amplitude of the rise. Such measures have the potential both to improve cardiovascular risk assessment and to be used as treatment targets. While this appears to encapsulate what is thought likely to be of the most relevance to cardiovascular risk, the value of the rate and power of the morning surge has not been evaluated scientifically. These techniques are now being applied in a wide range of collaborative projects at the Baker Institute, within Australia and also internationally. Together with colleagues from Japan and Monash University, we are developing mathematical and epidemiological models to predict cardiovascular risk based on ABP indices, incorporating our new method of analysis of ABP recordings from Japan and Australia. Importantly, we have now completed a population assessment of ABP within Australia as part of the AusDiab study.