Blog

Kolling Institute researcher and RNSH Senior Hospital Scientist Dr Anastasia Mihailidou says she was delighted to showcase the district’s work in blood pressure management on the world stage.

Dr Mihailidou, who is head of the Kolling’s Cardiovascular and Hormonal Research Lab, presented at the recent International Society of Hypertension Scientific Meeting in Japan.

Globally renowned academics and clinicians were among those who attended the event, which profiled the latest clinical and biomedical research into the treatment of hypertension.

“I was excited to talk about my professional passion about accurate blood pressure measurement,” said Dr Mihailidou, who presented on Hypertension Therapy Using Diagnostic Service for Ambulatory Blood Pressure Monitoring.

“I am proud that my work was considered of interest to the international community involved with this meeting.

“Outlining some of the work being done in this area locally was a great honour not only for myself, but for Royal North Shore Hospital and the Northern Sydney Local Health District.”

This was the ISH’s 29th Scientific Meeting, which this year had the theme, ‘The Wisdom for Conquering Hypertension.’

The five-day event, which took place in the Japanese city of Kyoto, featured several presentations on issues including technological developments and the impact of diet and COVID-19 on cardiovascular health.

Presenting at the event was the latest accolade for Dr Mihailidou, who has previously been appointed by The Lancet to the Commission on Cardiovascular Disease in Women.

Her work has informed clinical practice nationally through the development of the Australian Guidelines for Ambulatory Blood Pressure Monitoring.

Dr Mihailidou, who is also Education Portfolio Executive Member with the High Blood Pressure Research Council, said it had been terrific to present at the meeting.

“I felt it was important to address some of the misinformation that has come from different sources but also confirm what I believe to be the most accurate method in the management and detection of blood pressure,” she said.

“To present was a great honour for myself personally, but I’m ecstatic that a global audience was exposed to the work being done here in the District.”

With a disturbing number of people losing their lives to heart disease each year, researchers have launched the first study of its kind using MRI technology to broaden our understanding of the link between cardiovascular disease and sleep apnoea.

The project has been made possible following funding from the Ramsay Research Grant Program, and will involve clinician researchers from Northern Sydney Local Health District and the University of Sydney.

It follows the latest figures showing cardiovascular disease is the leading cause of death worldwide, killing one Australian every 12 minutes.

This makes the research important and timely, especially given that obstructive sleep apnoea is also increasing, and is now affecting around a billion people. Known as the silent killer, this chronic disease causes low oxygen levels, sleep disturbance and dangerous pressure inside the chest.

Royal North Shore Hospital respiratory and sleep medicine specialist Professor Peter Cistulli will lead the study, collaborating with RNSH Head of Respiratory and Sleep Medicine Dr Ben Harris, and Kolling Institute researchers Professor Martin Ugander and Dr Rebecca Kozor, who are experts in cardiac imaging. 

Professor Cistulli said obstructive sleep apnoea has been linked to the development of cardiovascular disease, including hypertension, heart attack, atrial fibrillation and stroke – but there have been no randomised controlled trials confirming a causal link between the two.

“Our CardioSleep Program will be unique, uniting three major disciplines of cardiology, respiratory and sleep medicine, and radiology to develop a precision medicine approach. This would define which patients are at greatest risk and require personalised treatment,” he said.

“We hope our project will provide definitive evidence of the relationship between sleep apnoea and cardiovascular disease, closing our existing gaps in knowledge and informing future treatment approaches.

“We would like to see this valuable research program drive a new approach, and one which will dramatically reduce the number of number of people who lose their lives prematurely with a combination of sleep apnoea and cardiovascular disease.”

Research from the University of Sydney and Royal North Shore Hospital provides insights into cardiac risk among footballers of masters age (35 years and older), an increasingly popular pastime.

In what is believed to be the first study to assess cardiac knowledge and beliefs in this higher-risk amateur football group, researchers have found that one in five players experienced one or more potential cardiac symptoms while playing in the past year, but only one in four of them sought medical attention.

The findings from the survey were published today in the Royal Australasian College of Physicians’ peer-reviewed journal The Internal Medicine Journal.

Associate Professor Tom Buckley from the University of Sydney’s Faculty of Medicine and Health explained although regular exercise improves health, he and others have shown previously that strenuous exercise can cause a temporary increase in risk of heart attack and sudden death.

“Although events during sport may be rare, each death is a tragedy and insight into motivations and health behaviours of masters’ players helps plan preventative approaches,” he said.

“It is important for people to recognise and act quickly on symptoms when participating in sports events,” Associate Professor Buckley said.

“Our research is also relevant for other sports besides football, which is the most common masters team sport.”

Professor Geoffrey Tofler, senior author of the paper, and Professor of Preventative Cardiology at Sydney Medical School and cardiologist at Royal North Shore Hospital, says:

“Although regular exercise improves health, the temporary increase in cardiac risk during strenuous exercise reinforces that it is important to recognise the warning signs of an impending cardiac event.

“If a cardiac arrest occurs, acting promptly with CPR and defibrillator availability is critical.”

“Our research provides insights for masters football players and other masters players so that they can continue to enjoy the benefits of weekend amateur sport but know when to seek help if required.”

Some key findings include:

• 21.6 percent experienced at least one potential cardiac symptom during physical activity in the preceding 12 months, but only 24.2 percent of them sought medical advice.
• Almost half (49.6 percent) had little or no confidence that they would recognise a heart attack in themselves, with even less expressing confidence in recognising one in others.
• In response to a hypothetical episode of chest pain while playing, less than half (46.6 percent) would leave the field immediately, while 49 percent would stay on the field for 5-10 minutes to see if the pain eased, and several A grade (16.6 percent) and B grade (2.2 percent) players would continue playing until their performance became unsatisfactory or until the end of the game.
• Three quarters (76.5 percent) said they would use the internet for information about their symptoms before seeing a doctor.
• Although knowledge of typical heart attack symptoms was high (>80 percent) it was lower (<40 percent) for less typical symptoms.
• One high-risk attitude was that nearly half (45 percent) said if they thought they were having a heart attack, they would prefer someone to drive them to the hospital rather than have an ambulance come to their home.
• While most (81.7 percent) would see a doctor within one week of experiencing a health problem such as chest pain, 18.3 percent would wait longer or not go.
• A positive response was that prevention strategies were strongly supported by participants, in particular, defibrillator availability at games and training in their use, and educational information about cardiac health and warning symptoms.

About the study

Lead author Dr Matthew Francis said the Masters Football and Cardiovascular Risk survey collected self-reported, anonymous data via a web-based questionnaire, which sampled 153 amateur masters footballers from Sydney.

Participants were of average age 49.3 ± 7.5 years, mainly male (92 percent), and from A -grade competition, B- or lower-grade competition and social games. Competitive drive and intensity of emotions while playing was greatest in the competition players.

Dr Francis said that almost three quarters (73.3 percent) had played football for at least five years since 35 years of age, and participants exercised or played sport an average of 3.6 days per week.

The most popular reasons for playing football were social interaction and enjoyment (93.5 percent), health and exercise (89.5 percent) and love of football (79.7 per cent).

Co-author Mr Alexander Tofler, a student at the Susan Wakil School of Nursing and Midwifery, said players were invited to participate through researcher attendance at team sessions, or telephone and email communication with team and area coordinators who distributed study information.

Because the level of education was high in survey participants (75 percent had university degrees), the findings may be a best-case scenario, assuming those with a lower educational level may have less awareness about cardiac issues.

To find out more about heart-attack causes, warning signs and what to do, people are encouraged to visit the Heart Foundation resource page.  

The largest study of its kind in Australia has found patients with a history of heart failure are three times more likely to die from COVID-19.

Launched last year at the outset of the pandemic, the AUS-COVID trial is investigating those who are most at risk from COVID-19 in Australia. To date, it has assessed hundreds of patients in 21 hospitals across the country.

The study confirmed earlier concerns by clinicians and demonstrated that patients with pre-existing heart failure are three times more likely to die from COVID-19. Over 100,000 Australians live with heart failure according to data from the Australian Bureau of Statistics.

The study found that patients with chronic kidney disease are twice are likely to die from COVID-19, while patients with chronic lung disease such as emphysema or chronic bronchitis are also around twice as likely to die from the virus.

Kolling researcher and Head of Cardiology at Royal North Shore Hospital Professor Ravinay Bhindi said the findings have provided valuable data to assist in the treatment of new cases of COVID-19.

“The research is providing timely advice for clinicians, helping them identify the patients most likely to deteriorate and therefore in need of a higher level of care,” he said.

“These patient outcomes and emerging trends are also underpinning the importance of vaccination.

“It’s critical that all patients with heart failure and other chronic conditions are vaccinated against COVID-19. We now have the data to show that if you have one of these chronic conditions and you’re not vaccinated when you get COVID-19, you are much more likely to die.

“Our research is based on hundreds of cases across Australia, many with tragic outcomes. It’s important that we use this information to inform the care we provide for patients, and address any vaccine hesitancy with real-life experience.”