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MacGregor and colleagues working at St George's have provided extensive clinical and epidemiological evidence that has changed UK government policy on recommendations for salt intake. In 2011 NICE recommended continued reduction in dietary salt intake in the UK. A 3 gm reduction in daily salt intake is calculated to result in 14-20,000 fewer deaths from cardiovascular disease annually, a saving of approximately £350 million in healthcare costs, and the gain of 130,000 quality-adjusted life years. The global benefits of this policy have been recognised with the WHO making recommendations for similar levels of salt reduction worldwide.
Research in Leeds has identified independent risk factors associated with pressure ulcer development and made a significant contribution to the evidence base for choosing the most cost- effective mattress to prevent pressure ulcers. Through publication and subsequent integration into systematic reviews/ practice guidelines, and membership of committees the research has been disseminated to policy makers and practitioners. Leeds evidence is now included in international guidelines in at least 17 languages. This has led to a change in clinical and purchasing practice with likely reduction in the number of pressure ulcers and health service cost.
The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT; Co-Chairman, Professor Sever) was an investigator designed and led multinational study in which different blood pressure-lowering and lipid-lowering treatment strategies were investigated in an attempt to define optimal programmes for intervention to prevent cardiovascular disease in hypertensive subjects. The outcomes of both the antihypertensive arm and the lipid arm of the trial defined the benefits of more contemporary treatments for hypertensive subjects, including calcium channel blockers, angiotensin converting enzyme inhibitors and statins, which have been incorporated into national and international guidelines (including NICE), and have impacted on current clinical practice in the prevention of cardiovascular disease worldwide.
Professor Kim Parker in the Department of Bioengineering has developed Wave Intensity Analysis (WIA) for characterising pressure and flow waves in arteries. It is being used to assess whether patients need interventions to reduce narrowing of their coronary arteries. Conventional diagnoses require the use of a drug that is costly, time consuming to administer and has unpleasant side effects; it cannot be used in some patient groups. WIA obviates the need for the drug and can be used as the sole diagnostic method in more than half of patients. After being assessed in trials involving >2500 patients, the method became commercially available, and is in routine clinical use in 3 continents. It removes the cost of the drug (which can be US$500 per case in some countries), increases throughput by halving the time taken for the procedure, reduces side effects and makes rigorous diagnosis available to patient groups that cannot tolerate the drug and therefore depended on unreliable, imaging-based methods until now.
A novel pressure-relieving technology has been developed to enhance the quality of life of a range of people. This has enabled the development firstly of a novel compression therapy system for the prevention and treatment of venous leg ulcers especially for middle-aged and older communities as well as having the potential for huge savings to the NHS. Secondly, is a unique pressure-relieving cushion to reduce pressure sores with specific applications for wheelchair users. Baltex Ltd, UK are successfully producing both commercially. An exclusive agreement has been signed with a global medical device company, BSN Medical for marketing the single-layer bandage.
Novel work undertaken at this centre has demonstrated that vitamin B2 (riboflavin) can significantly decrease BP, specifically in people with a common genetic variant affecting the folate-metabolising enzyme MTHFR. The extent of BP-lowering demonstrated is as good as that expected from BP-lowering drugs and much better than that found with common dietary approaches and furthermore, the effect is independent of concurrent BP-lowering drugs. These findings offer a simple, cost-effective targeted treatment for the management of BP in this genetically at-risk group. The global prevalence of this genetic variant is 10% but can be as high as 32% in other countries such as Mexico and Northern China.
High blood pressure (or hypertension) is the major cause of stroke and other cardiovascular disease, and is one of the most important preventable causes of morbidity and mortality in developed and developing countries. In the UK it affects half the population over 60 and costs the NHS £1Bn per year in drugs alone.
A University of Birmingham primary care-led study has provided definitive evidence of the superiority of ambulatory blood pressure measurement (ABPM) over clinic and home blood pressure monitoring as a means of diagnosing hypertension. The associated cost-effectiveness study showed that this approach will save the NHS over £10.5M per year. As a result of this research, NICE guidelines have been amended and ABPM has become the reference standard. The research has also influenced public and policy debate in the UK and internationally.
This research provided the first evidence that long-chain polyunsaturated fatty acids (LCPUFAs) added to infant formula improve the development of specific cognitive abilities. Manufacturers of infant formula have included the research in their submissions to regulatory authorities to justify inclusion of LCPUFAs in infant formula. The research is also included in information and advice on infant feeding provided by manufacturers for the general public. Between 2008 and 2013, the research has been cited by national and international organisations in connection with recommendations for dietary intakes of LCPUFAs and policy on infant nutrition. Formulas enriched with LCPUFA are now available in most countries, and the formula-fed infants worldwide receive the benefits of LCPUFAs.
Mathematical models of violent flows developed by Dr Mark Cooker at UEA have been adopted by industry. The work enhances the capabilities of coastal engineers to design and repair seawalls and coastal structures, and enhances their interpretation of damage inflicted by storm waves. The research has direct industrial application, and is used to contain, interpret and lessen sea-wave damage to structures. Commercial software has proved inadequate in this field, compared with Cooker's mathematical modelling, because computations alone cannot resolve the brief time- scales and short length-scales over which there are large changes in pressure, and sudden excursions of the liquid as splashes. An example of this impact is the design of an observation gantry exposed to storm waves.
Two multicentre clinical trials conducted by Professor Potter have contributed to revised international guidelines for the management of hypertension following acute stroke, the single largest cause of adult disability worldwide. Before these trials, there was little evidence on the effects of using antihypertensive drugs immediately after stroke and there was concern that use of these drugs could extend the stroke. The trials found no serious adverse effects of using antihypertensive drugs immediately after stroke whilst mortality after 3 months was halved. The American Heart Association, the European Societies of Hypertension and of Cardiology, and the Royal College of Physicians all reference these trials in support of their recent Guidelines, thereby promoting better patient care and improved outcomes.