Professor James Sharman

Deputy Director, Menzies Institute for Medical Research, Medical Science Precinct, Hobart CBD Campuses, Hobart, Tasmania, Australia

For generations, doctors have based blood pressure management on measurements taken at the upper-arm. It appears, however, that a more reliable measure of blood pressure is ‘central’ pressure—that of the major vessels supplying the organs—which has immense implications for how we will treat high blood pressure in the future. Professor James Sharman’s research in this area might revolutionise the way we diagnose and treat blood pressure abnormalities.

Thriving under pressure

Measuring central blood pressure offers a more useful diagnostic tool than the traditional upper-arm test.

James’s Blood Pressure Research Group is working on a series of studies ranging from understanding the basic human physiology of blood pressure to exploring new methods for improving patient diagnosis and care. These new methods include a means of measuring central blood pressure – the blood pressure experienced by the organs – rather than the pressure in the upper arm, which has been the standard for many years.

‘Central blood pressure has been shown to be more important than upper-arm blood pressure in terms of cardiovascular risk and managing high blood pressure, but doctors don’t routinely measure central pressure. They generally rely on upper-arm pressure to assess, diagnose and prescribe medication. Some of our work aims to make progress towards improving this management process,’ said James.

‘We are also trying to determine whether blood pressure measured during exercise has clinical usefulness as a means to identify people at higher risk who would otherwise go unnoticed by standard medical screening. This is also proving to be a very worthwhile area of enquiry.’

James and his team recently completed a national, multi-centre clinical trial that has shown that using central blood pressure methods to guide the care of patients with high blood pressure results in significantly less use of medication to achieve effective blood pressure control. This is a world-first study and the findings are expected to eventually lead to better ways to assess blood pressure and manage hypertension.

‘We recently finished a study of cardiovascular physiology in patients during open heart surgery to understand the role of the central large arteries in determining central blood pressure. We need this information in order to appropriately target treatment. The results suggest an entirely new explanation than those offered by traditional textbooks,’ said James.

‘The most exciting and interesting aspect of being a researcher is finding a hypothesis coming true after years of work.’

‘Breaking through established scientific belief systems is a major and persistent challenge, particularly when your results suggest that a major change in approach is needed. The most exciting and interesting aspect of being a researcher is finding a hypothesis coming true after years of work,’ said James.

James is the leader of the Cardiometabolic Health and Diseases research theme at Menzies.

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