Imperial College London

Professor Neil Poulter

Faculty of MedicineSchool of Public Health

Professor of Preventive Cardiovascular Medicine.
 
 
 
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Contact

 

+44 (0)20 7594 3446n.poulter

 
 
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Assistant

 

Mrs Ranjit Rayat +44 (0)20 7594 3445

 
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Location

 

55Stadium HouseWhite City Campus

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Summary

 

Publications

Publication Type
Year
to

793 results found

Myanganbayar M, Boldbaatar K, Tuvdendarjaa K, Beaney T, Partington G, Baatarsuren U, Bayarsaikhan N-E, Davaadamdin O, Bungert A, Campbell NRC, Poulter NR, Dashdorj Net al., 2021, May Measurement Month 2019: an analysis of blood pressure screening results from Ulaanbaatar, Mongolia, EUROPEAN HEART JOURNAL SUPPLEMENTS, Vol: 23, Pages: B107-B109, ISSN: 1520-765X

Journal article

Chen X, Liu C-Y, Xu L-Y, Wang H-Y, Liu M, Zhang Y-Q, Yin X-H, Wang X-L, Yu J, Li W-H, Beaney T, Xia X, Poulter NR, Li Y, Wang J-Get al., 2021, May Measurement Month 2019: an analysis of blood pressure screening results from China, EUROPEAN HEART JOURNAL SUPPLEMENTS, Vol: 23, Pages: B43-B45, ISSN: 1520-765X

Journal article

Tsinamdzgvrishvili B, Gamkrelidze A, Trapaidze D, Sturua L, Grdzelidze N, Abesadze T, Mebonia N, Shengelia L, Giuashvili N, Gogilashvili N, Odisharia N, Alavidze S, Beaney T, Partington G, Poulter NRet al., 2021, May measurement month 2019: blood pressure screening results in Georgia, Europe, European Heart Journal Supplements, Vol: 23, Pages: B59-B61, ISSN: 1520-765X

May Measurement Month is a global campaign aimed at raising public awareness of hypertension and to improve the management of hypertension—the main risk factor for cardiovascular diseases in the population. Screening was carried out at 400 sites on a national scale. More than 500 volunteers, including physicians (80%) and students of medical universities (20%) participated in the screening. To familiarize them with the research tools and standard blood pressure (BP) measurement method, they were trained by the members of the Georgian Society of Hypertension and the National Center for Disease Control and Public Health’s staff. Medical societies, health-care professionals, public health workers, social mass media, and other stakeholders were actively involved in the recruitment process. A total of 13 267 (38.5% males and 61.5% females) individuals were screened. The mean age of participants was 54.7 years (SD 15.9). All participants were Caucasian. After imputation of missing BP readings, 8510 (64.1%) were found to have hypertension, out of whom 7269 (85.4%) were aware of their condition, 7232 (85.0%) were on medication, and 1278 (15.0%) were not taking any medication. Of those taking antihypertensive medication, 34.8% had their BP controlled (<140/90 mmHg). May Measurement Month detected a high proportion of participants with hypertension, with results indicating low rates of control in Georgia.

Journal article

Patil M, Jose AP, More A, Maheshwari A, Verma N, Shah R, Kaur A, Kaushik A, Sepat P, Beaney T, Clarke J, Bagadia L, Jadhav S, Poulter NR, Prabhakaran Det al., 2021, May Measurement Month 2019: an analysis of blood pressure screening results from India (vol 23, pg B73, 2021), European Heart Journal Supplements, Vol: 23, Pages: B161-B161, ISSN: 1520-765X

Journal article

Molinero A, Calvo E, Beaney T, Day E, Prats-Mas R, Fornos JA, Mera-Gallego I, Tous S, de Andrés NF, Rodilla E, Gijón T, Pérez-Manchon D, Poulter NR, Ruiz-Hurtado G, Ruilope LMet al., 2021, May Measurement Month 2019: an analysis of blood pressure screening results from Spain., European Heart Journal Supplements, Vol: 23, Pages: B138-B140, ISSN: 1520-765X

The aim of the May Measurement Month (MMM) is devoted to better understanding the awareness, treatment, and control rates of hypertension in Spain. Presented here are the data corresponding to 2019 campaign. In 2019, a total of 4433 patients (61.5% males) with a mean age of 54.8 years were included. Of all, 96.0% were Caucasian, and 3294 were recruited in pharmacies. The mean values of systolic blood pressure (BP) were 125.6 and of diastolic 76.7 mmHg in the whole population. The most recent previous BP measurement took place more than 1 year before in 27.6% of participants. A total of 1883 were hypertensive (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or taking antihypertensive medication), of whom 77.2%/were aware and 71.1% were on medication. Of all, 64.9% of those on medication and 46.1% of all hypertensive participants had a BP controlled to <140/90 mmHg. These data from MMM 2019 continue to indicate the need for an improvement in the awareness, treatment, and control of hypertension in Spain.

Journal article

Carnagarin R, Yang J, Critchley S, Picone D, Tan I, Marques FZ, Cowley D, Fernando M, Beaney T, Trengrove N, Omelczuk S, Poulter NR, Brockman D, Schlaich MPet al., 2021, May Measurement Month 2019: an analysis of blood pressure screening results from Australia., European Heart Journal Supplements, Vol: 23, Pages: B18-B20, ISSN: 1520-765X

May Measurement Month (MMM) is an annual global blood pressure (BP) screening campaign aimed at obtaining standardized BP measurements and other relevant health information from members of the community to increase awareness of elevated BP and the associated risks. Adults (≥18 years) were recruited through opportunistic sampling across the various Australian states during May 2019. Three BP readings were recorded in a standardized manner for each participant, and data on lifestyle factors and comorbidities were collected. Hypertension was defined as a systolic BP ≥140 mmHg, or a diastolic BP ≥90 mmHg (according to the MMM protocol) or taking antihypertensive medication. Multiple imputation was used to estimate participants' mean BP where three readings were not available. Of the 2877 participants, 901 (31.3%) had hypertension of whom 455 (50.5%) were aware of their condition, and 366 (40.6%) were on antihypertensive medication. Of those taking antihypertensive medication, 54.3% were controlled to <140/90 mmHg with the remaining 45.7% of participants inadequately treated. Approximately 74% of treated patients were on a single antihypertensive medication. The MMM campaign provides an important platform for standardized compilation of BP data and creation of BP awareness in Australia and other nations worldwide. Data from the 2019 MMM campaign highlight that BP control rates in Australia remain unacceptably low.

Journal article

Haj Amor S, Beaney T, Saidi O, Clarke J, Poulter NR, Ben Alaya N, Ben Romdhane H, MMM Tunisian Working Groupet al., 2021, May Measurement Month 2019: an analysis of blood pressure screening results from Tunisia., European Heart Journal Supplements, Vol: 23, Pages: B144-B146, ISSN: 1520-765X

We performed a May Measurement Month (MMM) screening campaign among adult volunteers aged 18 years old and over in Tunisia. The objective was to raise awareness, and to estimate the prevalence, awareness, treatment, and control of hypertension, one of the main cardiovascular risk factors. Following the MMM protocol, three blood pressure (BP) measurements were taken by physicians and standard interviewing procedures were used to record medical history, socio-demographic, and cardiovascular disease risk factors. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or treatment with antihypertensive medication. From 11 271 adults screened, the prevalence of hypertension was 38.1%. Among those with hypertension, 72.5% were aware of their diagnosis, and 67.5% were treated. BP control was achieved in only 38.2% of all those with hypertension. The study highlights the magnitude of hypertension in Tunisia. There is an urgent need for implementing a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension.

Journal article

Williams B, Unger T, Schutte AE, Tomaszewski M, Poulter NR, 2020 ISH Global Hypertension Practice Guidelines Committeeet al., 2021, Reply., J Hypertens, Vol: 39, Pages: 813-814

Journal article

Al-Riyami H, Nadar S, Al-Riyami A, Panakkal B, Mohammed S, Gb N, Sharma S, Beaney T, Ster A, Poulter Net al., 2021, MAY MEASUREMENT MONTH: DATA FROM A NATIONAL SCREENING PROGRAMME IN OMAN IN 2017 AND 2018, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E270-E270, ISSN: 0263-6352

Conference paper

Harvey G, Godec T, Kapil V, Mackay J, Whitehouse A, Poulter N, Sever PS, Gupta Aet al., 2021, COMPARING THE DISCRIMINATIVE ABILITY OF DIFFERENT ELECTROGRAPHIC CRITERIA FOR LEFT VENTRICULAR HYPERTROPHY IN PREDICTING CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E165-E166, ISSN: 0263-6352

Conference paper

Lin Q, Ye T, Beaney T, Poulter NRet al., 2021, THE ASSOCIATIONS BETWEEN HYPERTENSION AND STROKE FROM MAY MEASUREMENT MONTH AND BETWEEN NATIONAL HYPERTENSION PARAMETERS WITH STROKE MORTALITY FROM THE GLOBAL BURDEN OF DISEASE, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E30-E30, ISSN: 0263-6352

Conference paper

Al-Riyami H, Nadar S, Al-Riyami A, Panakkal B, Mohammed S, Gb N, Sharma S, Beaney T, Ster A, Poulter Net al., 2021, MAY MEASUREMENT MONTH: DATA FROM A NATIONAL SCREENING PROGRAMME IN OMAN IN 2017 AND 2018, Joint Meeting of the European-Society-of-Hypertension (ESH) and International-Society-of-Hypertension (ISH), Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E270-E270, ISSN: 0263-6352

Conference paper

Gupta A, Godec T, Mackay J, Whitehouse A, Rostamian S, Collier T, Poulter N, Sever Pet al., 2021, INFLUENCE OF AGE, SEX AND AN OCCURRENCE OF CARDIOVASCULAR EVENT ON SEASONAL VARIATIONS IN BLOOD PRESSURES IN HYPERTENSIVE PATIENTS: INSIGHTS FROM THE ASCOT COHORT, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E145-E146, ISSN: 0263-6352

Conference paper

Gupta A, Rostamian S, Mackay J, Godec T, Whitehouse A, Poulter N, Sever Pet al., 2021, THE DEVELOPMENT OF RESISTANT HYPERTENSION INDEPENDENT OF THE PRECEDING PERIOD OF THE BLOOD PRESSURE CONTROL IS ASSOCIATED WITH THE INCREASED RISK OF CARDIOVASCULAR EVENTS AND DEATH, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E358-E358, ISSN: 0263-6352

Conference paper

Surendran P, Feofanova EV, Lahrouchi N, Ntalla I, Karthikeyan S, Cook J, Chen L, Mifsud B, Yao C, Kraja AT, Cartwright JH, Hellwege JN, Giri A, Tragante V, Thorleifsson G, Liu DJ, Prins BP, Stewart ID, Cabrera CP, Eales JM, Akbarov A, Auer PL, Bielak LF, Bis JC, Braithwaite VS, Brody JA, Daw EW, Warren HR, Drenos F, Nielsen SF, Faul JD, Fauman EB, Fava C, Ferreira T, Foley CN, Franceschini N, Gao H, Giannakopoulou O, Giulianini F, Gudbjartsson DF, Guo X, Harris SE, Havulinna AS, Helgadottir A, Huffman JE, Hwang S-J, Kanoni S, Kontto J, Larson MG, Li-Gao R, Lindstrom J, Lotta LA, Lu Y, Luan J, Mahajan A, Malerba G, Masca NGD, Mei H, Menni C, Mook-Kanamori DO, Mosen-Ansorena D, Muller-Nurasyid M, Pare G, Paul DS, Perola M, Poveda A, Rauramaa R, Richard M, Richardson TG, Sepulveda N, Sim X, Smith AV, Smith JA, Staley JR, Stanakova A, Sulem P, Theriault S, Thorsteinsdottir U, Trompet S, Varga TV, Velez Edwards DR, Veronesi G, Weiss S, Willems SM, Yao J, Young R, Yu B, Zhang W, Zhao J-H, Zhao W, Zhao W, Evangelou E, Aeschbacher S, Asllanaj E, Blankenberg S, Bonnycastle LL, Bork-Jensen J, Brandslund I, Braund PS, Burgess S, Cho K, Christensen C, Connell J, de Mutsert R, Dominiczak AF, Dorr M, Eiriksdottir G, Farmaki A-E, Gaziano JM, Grarup N, Grove ML, Hallmans G, Hansen T, Have CT, Heiss G, Jorgensen ME, Jousilahti P, Kajantie E, Kamat M, Karajamaki A, Karpe F, Koistinen HA, Kovesdy CP, Kuulasmaa K, Laatikainen I, Lannfelt L, Lee I-T, Lee W-J, Linneberg A, Martin LW, Moitry M, Nadkarni G, Neville MJ, Palmer CNA, Papanicolaou GJ, Pedersen O, Peters J, Poulter N, Rasheed A, Rasmussen KL, Rayner NW, Magi R, Renstrom F, Rettig R, Rossouw J, Schreiner PJ, Sever PS, Sigurdsson EL, Skaaby T, Sun YV, Sundstrom J, Thorgeirsson G, Esko T, Trabetti E, Tsao PS, Tuomi T, Turner ST, Tzoulaki I, Vaartjes I, Vergnaud A-C, Willer CJ, Wilson PWF, Witte DR, Yonova-Doing E, Zhang H, Aliya N, Almgren P, Amouyel P, Asselbergs FW, Barnes MR, Blakemore AI, Boehnke M, Bots ML, Bottinger EP, Buriet al., 2021, Publisher Correction: Discovery of rare variants associated with blood pressure regulation through meta-analysis of 1.3 million individuals, Nature Genetics, Vol: 53, Pages: 1-2, ISSN: 1061-4036

Journal article

Gnanenthiran SR, Borghi C, Burger D, Charchar F, Poulter NR, Schlaich MP, Steckelings UM, Stergiou G, Tomaszewski M, Unger T, Wainford RD, Williams B, Rodgers A, Schutte AEet al., 2021, Prospective meta-analysis protocol on randomised trials of renin-angiotensin system inhibitors in patients with COVID-19: an initiative of the International Society of Hypertension, BMJ Open, Vol: 11, Pages: 1-7, ISSN: 2044-6055

Introduction Whether ACE inhibitors (ACEi) or angiotensin II receptor blocker (ARB) therapy should be continued, initiated or ceased in patients with COVID-19 is uncertain. Given the widespread use of ACEi/ARBs worldwide, guidance on the use of these drugs is urgently needed. This prospective meta-analysis aims to pool data from randomised controlled trials (RCTs) to assess the safety and efficacy of ACEi/ARB therapy in adults infected with SARS-CoV-2.Methods and analysis RCTs will be eligible if they compare patients with COVID-19 randomised to ACEi/ARB continuation or commencement versuss no ACEi/ARB therapy; study duration ≥14 days; recruitment completed between March 2020 and May 2021. The primary outcome will be all-cause mortality at ≤30 days. Secondary outcomes will include mechanical ventilation, admission to intensive care or cardiovascular events at short-term follow-up (≤30 days) and all-cause mortality at longer-term follow-up (>1 month). Prespecified subgroup analyses will assess the effect of sex; age; comorbidities; smoking status; ethnicity; country of origin on all-cause mortality. A search of ClinicalTrials.gov has been performed, which will be followed by a formal search of trial registers, preprint servers, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials to identify RCTs that meet inclusion criteria. To date, a search of ClinicalTrials.gov identified 21 potentially eligible trials for this meta-analysis. We will request trial investigators/sponsors to contribute standardised grouped tabular outcome data.Ethics and dissemination Ethics approval and informed consent will be the responsibility of the individual RCTs. Dissemination of results will occur by peer-reviewed publication. The results of our analysis can inform public health policy and clinical decision making regarding ACEi/ARB use in patients with COVID-19 on a global scale.

Journal article

Oshima M, Hara A, Toyama T, Jun M, Pollock C, Jardine M, Harrap S, Poulter N, Cooper ME, Woodward M, Chalmers J, Perkovic V, Wong MG, Wada Tet al., 2021, Comparison of circulating biomarkers in predicting diabetic kidney disease progression with autoantibodies to erythropoietin receptor, Kidney International Reports, Vol: 6, Pages: 284-295, ISSN: 2468-0249

IntroductionSeveral circulating markers, including autoantibodies to erythropoietin receptor (anti-EPOR antibodies), have been identified as useful biomarkers in predicting diabetic kidney disease progression. However, a direct comparison of their utility is lacking. We aimed to validate and to compare the prognostic value of anti-EPOR antibodies with that of other known biomarkers, using the ADVANCE trial and its long-term follow-up, ADVANCE-ON, cohorts.MethodsIn this nested case-control study from the ADVANCE trial cohort, we included 165 case participants who had the composite kidney outcome (renal replacement therapy, renal death, or doubling of serum creatinine to ≥200 μmol/l) and 330 matched controls. We compared the associations of baseline plasma levels of anti-EPOR antibodies, tumor necrosis factor receptor (TNFR)-1 and -2, and bone morphogenetic protein (BMP)-7 with kidney outcomes.ResultsCases had higher baseline plasma levels of anti-EPOR antibodies than controls (median 1.7 vs. 0.6 enzyme-linked immunosorbent assay unit, P < 0.001). Higher levels of anti-EPOR antibodies were associated with an increased risk of kidney outcome (odds ratio 2.16 [95% confidence interval 1.51, 3.08], per 1 SD of log-transformed levels) after adjusting for conventional markers. Elevated circulating TNFR1 and TNFR2 levels, and lower BMP-7 levels at baseline, were associated with poor kidney outcome (odds ratios 2.06 [1.29, 3.30], 1.66 [1.13, 2.43], and 0.45 [0.32, 0.65], respectively). The addition of anti-EPOR antibodies into the model improved the prediction of kidney outcome, regardless of other biomarkers.ConclusionAnti-EPOR antibodies provide a promising biomarker, as with TNFR1, TNFR2, and BMP-7, in predicting kidney disease progression in people with type 2 diabetes mellitus.

Journal article

Mohammedi K, Harrap S, Mancia G, Marre M, Poulter N, Chalmers J, Woodward Met al., 2021, History of lower-limb complications and risk of cancer death in people with type 2 diabetes, Cardiovascular Diabetology, Vol: 20, Pages: 1-12, ISSN: 1475-2840

BackgroundIndividuals with diabetes and lower-limb complications are at high risk for cardiovascular and all-cause mortality, but uncertainties remain in terms of cancer-related death in this population. We investigated this relationship in a large cohort of people with type 2 diabetes.MethodsWe used data from the Action in Diabetes and Vascular Disease: PreterAx and DiamicroN Modified-Release Controlled Evaluation (ADVANCE) study. The primary outcome was adjudicated cancer death; secondary outcomes were overall and site-specific incident cancers, determined according to the International Classification of Diseases Code (ICD-10). We compared outcomes in individuals with (versus without) a baseline history of lower-limb complications (peripheral artery disease (PAD) or sensory peripheral neuropathy) using Cox regression models.ResultsAmong 11,140 participants (women 42%, mean age 66 years), lower-limb complications were reported at baseline in 4293 (38%) individuals: 2439 (22%) with PAD and 2973 (27%) with peripheral neuropathy. Cancer death occurred in 316 (2.8%) participants during a median of 5.0 (25th–75th percentile, 4.7–5.1) years of follow-up corresponding to 53,550 person-years and an incidence rate of 5.9 (95% CI 5.3–6.6) per 1000 person-years. The risk of cancer death was higher in individuals with (versus without) lower-limb complication [hazard ratio 1.53 (95% CI, 1.21–1.94), p = 0.0004], PAD [1.32 (1.02–1.70), p = 0.03] or neuropathy (1.41 (1.11–1.79), p = 0.004], adjusting for potential confounders and study allocations. PAD, but not neuropathy, was associated with excess risk of incident cancers.ConclusionsPAD and peripheral neuropathy were independently associated with increased 5-year risk of cancer death in individuals with type 2 diabetes. PAD was also associated with increased risk of incident cancers. Our findings provide new evidence on the non-cardiovascular prognosti

Journal article

Heller S, Lingvay I, Marso SP, Philis-Tsimikas A, Pieber TR, Poulter NR, Pratley RE, Hachmann-Nielsen E, Kvist K, Lange M, Moses AC, Trock Andresen M, Buse JB, DEVOTE Study Groupet al., 2020, Development of a hypoglycaemia risk score to identify high-risk individuals with advanced type 2 diabetes in DEVOTE, Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics, Vol: 22, Pages: 2248-2256, ISSN: 1462-8902

AIMS: The ability to differentiate patient populations with type 2 diabetes at high risk of severe hypoglycaemia could impact clinical decision making. The aim of this study was to develop a risk score, using patient characteristics, that could differentiate between populations with higher and lower 2-year risk of severe hypoglycaemia among individuals at increased risk of cardiovascular disease. MATERIALS AND METHODS: Two models were developed for the risk score based on data from the DEVOTE cardiovascular outcomes trials. The first, a data-driven machine-learning model, used stepwise regression with bidirectional elimination to identify risk factors for severe hypoglycaemia. The second, a risk score based on known clinical risk factors accessible in clinical practice identified from the data-driven model, included: insulin treatment regimen; diabetes duration; sex; age; and glycated haemoglobin, all at baseline. Both the data-driven model and simple risk score were evaluated for discrimination, calibration and generalizability using data from DEVOTE, and were validated against the external LEADER cardiovascular outcomes trial dataset. RESULTS: Both the data-driven model and the simple risk score discriminated between patients at higher and lower hypoglycaemia risk, and performed similarly well based on the time-dependent area under the curve index (0.63 and 0.66, respectively) over a 2-year time horizon. CONCLUSIONS: Both the data-driven model and the simple hypoglycaemia risk score were able to discriminate between patients at higher and lower risk of severe hypoglycaemia, the latter doing so using easily accessible clinical data. The implementation of such a tool (http://www.hyporiskscore.com/) may facilitate improved recognition of, and education about, severe hypoglycaemia risk, potentially improving patient care.

Journal article

Heller S, Lingvay I, Marso SP, Philis-Tsimikas A, Pieber TR, Poulter NR, Pratley RE, Hachmann-Nielsen E, Kvist K, Lange M, Moses AC, Andresen MT, Buse JB, DEVOTE Study Groupet al., 2020, Risk of severe hypoglycaemia and its impact in type 2 diabetes in DEVOTE, Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics, Vol: 22, Pages: 2241-2247, ISSN: 1462-8902

AIMS: To undertake a post-hoc analysis, utilizing a hypoglycaemia risk score based on DEVOTE trial data, to investigate if a high risk of severe hypoglycaemia was associated with an increased risk of cardiovascular events, and whether reduced rates of severe hypoglycaemia in patients identified as having the highest risk affected the risk of cardiovascular outcomes. MATERIALS AND METHODS: The DEVOTE population was divided into quartiles according to patients' individual hypoglycaemia risk scores. For each quartile, the observed incidence and rate of severe hypoglycaemia, major adverse cardiovascular event (MACE) and all-cause mortality were determined to investigate whether those with the highest risk of hypoglycaemia were also at the greatest risk of MACE and all-cause mortality. In addition, treatment differences within each risk quartile [insulin degludec (degludec) vs. insulin glargine 100 units/mL (glargine U100)] in terms of severe hypoglycaemia, MACE and all-cause mortality were investigated. RESULTS: Patients with the highest risk scores had the highest rates of severe hypoglycaemia, MACE and all-cause mortality. Treatment ratios between degludec and glargine U100 in the highest risk quartile were 95% confidence interval (CI) 0.56 (0.39; 0.80) (severe hypoglycaemia), 95% CI 0.76 (0.58; 0.99) (MACE) and 95% CI 0.77 (0.55; 1.07) (all-cause mortality). CONCLUSIONS: The risk score demonstrated that a high risk of severe hypoglycaemia was associated with a high incidence of MACE and all-cause mortality and that, in this high-risk group, those treated with degludec had a lower incidence of MACE. These observations support the hypothesis that hypoglycaemia is a risk factor for cardiovascular events.

Journal article

Surendran P, Gao H, Zhang W, Evangelou E, Poulter N, Sever PJ, Vergnaud A, Chambers JC, Elliott P, Jarvelin M-R, Kooner JS, Howson Jet al., 2020, Discovery of rare variants associated with blood pressure regulation trhough meta-analaysis of 1.3 million individuals, Nature Genetics, Vol: 52, Pages: 1314-1332, ISSN: 1061-4036

Genetic studies of blood pressure (BP) to date have mainly analyzed common variants (minor allele frequency, MAF > 0.05). In a meta-analysis of up to >1.3 million participants, we discovered 106 new BP-associated genomic regions and 87 rare (MAF≤ 0.01) variant BP associations (P < 5 × 10-8), of which 32 were in new BP-associated loci and 55 were independent BP-associated SNVs within known BP-associated regions. Average effects of rare variants (44% coding) were ~8 times larger than common variant effects and indicate potential candidate causal genes at new and known loci (e.g.GATA5, PLCB3). BP-associated variants (including rare and common) were enriched in regions of active chromatin in fetal tissues, potentially linking fetal development with BP regulation in later life. Multivariable Mendelian randomization suggested possible inverse effects of elevated systolic and diastolic BP on large artery stroke. Our study demonstrates the utility of rare variant analyses for identifying candidate genes and the results highlight potential therapeutic targets.

Journal article

Ray KK, Schoonen WM, Catapano AL, Giovas P, Bray S, Molemans B, Poulter Net al., 2020, LIPID LOWERING THERAPY IN PRIMARY AND SECONDARY PREVENTION ACROSS EUROPE: ARE LDL-C GOALS ACHIEVED? RESULTS FROM THE DA VINCI STUDY, Publisher: ELSEVIER IRELAND LTD, Pages: E13-E13, ISSN: 0021-9150

Conference paper

Kim H, Wang D, Chalmers J, Jun M, Zoungas S, Marre M, Hamet P, Harrap S, Mancia G, Poulter NR, Cooper ME, Woodward M, Selvin E, Rebholz CMet al., 2020, Alternative kidney filtration markers and the risk of major macrovascular and microvascular events, andall-causemortality in individuals with type 2 diabetes in theADVANCEtrial, JOURNAL OF DIABETES, Vol: 12, Pages: 929-941, ISSN: 1753-0393

Journal article

Ryom L, Cotter A, De Miguel R, Béguelin C, Podlekareva D, Arribas JR, Marzolini C, Mallon P, Rauch A, Kirk O, Molina JM, Guaraldi G, Winston A, Bhagani S, Cinque P, Kowalska JD, Collins S, Battegay M, EACS Governing Boardet al., 2020, 2019 update of the European AIDS Clinical Society Guidelines for treatment of people living with HIV version 10.0, HIV Medicine, Vol: 21, Pages: 617-624, ISSN: 1464-2662

BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines cover key aspects of HIV management with major updates every two years. GUIDELINE HIGHLIGHTS: The 2019 Guidelines were extended with a new section focusing on drug-drug interactions and other prescribing issues in people living with HIV (PLWH). The recommendations for treatment-naïve PLWH were updated with four preferred regimens favouring unboosted integrase inhibitors. A two-drug regimen with dolutegravir and lamivudine, and a three-drug regimen including doravirine were also added to the recommended initial regimens. Lower thresholds for hypertension were expanded to all PLWH and for cardiovascular disease prevention, the 10-year predicted risk threshold for consideration of antiretroviral therapy (ART) modification was lowered from 20% to 10%. Frailty and obesity were added as new topics. It was specified to use urine albumin to creatinine ratio to screen for glomerular disease and urine protein to creatinine ratio for tubular diseases, and thresholds were streamlined with the Kidney Disease: Improving Global Outcomes (KDIGO) recommendations. Hepatitis C virus (HCV) treatment recommendations were split into preferred and alternative treatment options. The algorithm for management of recently acquired HCV infection was updated and includes recommendations for early chronic infection management. Treatment of resistant tuberculosis (TB) was streamlined with the World Health Organization (WHO) recommendations, and new tables on immune reconstitution inflammatory syndrome, on when to start ART in the presence of opportunistic infections and on TB drug dosing were included. CONCLUSIONS: The EACS Guidelines underwent major revisions of all sections in 2019. They are available in four different formats including a new interactive web-based version and are translated into Chinese, French, German, Japanese, Portuguese, Russian and Spanish.

Journal article

Amod A, Buse JB, McGuire DK, Pieber TR, Pop-Busui R, Pratley RE, Zinman B, Hansen MB, Jia T, Mark T, Poulter NR, DEVOTE Study Groupet al., 2020, Risk factors for kidney disorders in patients with type 2 diabetes at high cardiovascular risk: An exploratory analysis (DEVOTE 12), Diabetes and Vascular Disease Research, Vol: 17, ISSN: 1479-1641

AIM: To investigate risk factors associated with kidney disorders in patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk. METHODS: In DEVOTE, a cardiovascular outcomes trial, 7637 patients were randomised to insulin degludec (degludec) or insulin glargine 100 units/mL (glargine U100), with standard of care. In these exploratory post hoc analyses, serious adverse event reports were searched using Standardised MedDRA® Queries related to chronic kidney disease (CKD) or acute kidney injury (AKI). Baseline predictors of CKD, AKI and change in estimated glomerular filtration rate (eGFR) were identified using stepwise selection and Cox or linear regression. RESULTS: Over 2 years, eGFR (mL/min/1.73 m2) decline was small and similar between treatments (degludec: 2.70; glargine U100: 2.92). Overall, 97 and 208 patients experienced CKD and AKI events, respectively. A history of heart failure was a risk factor for CKD (hazard ratio [HR] 1.97 [95% confidence interval [CI] 1.41; 2.75]) and AKI (HR 2.28 [95% CI 1.64; 3.17]). A history of hepatic impairment was a significant predictor of CKD (HR 3.28 [95% CI 2.12; 5.07]) and change in eGFR (estimate: -8.59 [95% CI -10.20; -7.00]). CONCLUSION: Our findings indicate that traditional, non-modifiable risk factors for kidney disorders apply to insulin-treated patients with T2D at high CV risk. TRIAL REGISTRATION: NCT01959529 (ClinicalTrials.gov).

Journal article

Poulter N, Williams B, Unger T, 2020, 2020 International Society of Hypertension Guidelines: preference of calciumchannel blocker over thiazide-like diuretics lacks evidence Reply, JOURNAL OF HYPERTENSION, Vol: 38, Pages: 2336-2337, ISSN: 0263-6352

Journal article

Ray KK, Bray S, Catapano AL, Poulter N, Villa Get al., 2020, What is the potential cardiovascular risk reduction associated with achieving LDL-C levels recommended in the ESC/EAS guidelines for very high-risk patients? Data from 18 European countries, European-Society-of-Cardiology (ESC) Congress, Publisher: OXFORD UNIV PRESS, Pages: 3003-3003, ISSN: 0195-668X

Conference paper

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