Hypertension & Kidney Disease
Associate Professor Markus Schlaich
Head, Hypertension & Kidney Disease
markus.schlaich@bakeridi.edu.au
Laboratory Research Overview
Approximately two thirds of all strokes and half of all coronary disease world-wide can be attributed to nonoptimal blood pressure (hypertension). This represents ~7 million deaths and 64 million disability-adjusted life years each year, making hypertension the biggest killer globally.
The team of the Hypertension & Kidney Disease Laboratory is devoted to unravel the pathways and mechanisms responsible for elevated blood pressure in order to develop novel therapeutic strategies to curb the global burden of hypertension.
As an ESH (European Society of Hypertension) accredited Hypertension Excellence Centre we work on four major themes including:
- Hypertension resistant to conventional drug treatment
- Hypertension related to kidney disease
- Obesity related hypertension
- Hypertension in Indigenous Australians
The lab has particular focus on the role of the sympathetic nervous system in these scenarios and by combining our state-of-the-art technologies with genetic, protein based and biochemical testing from human blood and tissue samples we are uniquely positioned to undertake genuine translational research.
Research Focus
- Resistant hypertension.
- Hypertension related to kidney disease.
- Obesity related hypertension.
- Renal denervation.
- Sympathetic nervous activation in renal disease.
- Renalase in human health and disease.
- Noradrenaline transporter dysfunction in neural circulatory disorders
Research Projects
Resistant hypertension - causes, consequences and novel treatment options
Uncontrolled high blood pressure despite extensive drug treatment is a severe problem in ~25% of patients with hypertension but widely understudied. We aim to comprehensively assess their clinical phenotype and combine these data with results from our profiling facilities to unravel the mechanisms responsible for their resistance to treatment.
Change in office blood pressure (95% CI) at 1, 3, 6, 9, and 12 months post procedure
Renal denervation in patients with refractory hypertension
Renal sympathetic hyperactivity contributes substantially to hypertension. In a novel catheter based approach using radiofrequency energy we were able to demonstrate both the safety and the efficacy of the procedure resulting in substantial and sustained reductions in BP, without significant adverse events, in patients with resistant hypertension. This approach is likely to revolutionize the treatment of this high risk patient cohort.
Noradrenaline transporter dysfunction in neural circulatory disorders: clinical, molecular and therapeutic implications
Group leaders: Dr Gautam Vaddadi and Dr Elisabeth Lambert
Reuptake of noradrenaline by its transporter (NET) into sympathetic nerves terminates the neural signal. Reduced NET function augments the effects of sympathetic nerve traffic. Our studies provide evidence for an important role of altered NET function in three common conditions including hypertension, postural tachycardia syndrome, and neurally mediated syncope. We are currently exploring whether pharmacological inhibition of NETcan improve the clinical phenotype of neurally mediated syncope.
Role of sympathetic nervous activation in the pathogenesis and progression of human renal disease
Cardiovascular events are the major cause of morbidity and mortality in patients with renal failure. We are examining the role of the sympathetic nervous system and its contribution to the development of hypertension, the cardiovascular complications, and the progression of renal failure in these patients. We also explore the therapeutic benefits of direct inhibition of the sympathetic nervous system by means of drug treatment and renal denervation.
Delineating the physiological role of a novel soluble monoamine oxidase, renalase, in human health and disease
Group leaders: Dr Sarah Hennebry and Dr Nina Eikelis
Renalase, a protein expressed in the kidney, appeasr to play a role in blood pressure control, potentially by interference with the sympathetic nervous system. Using a combined genetic, molecular biology and integrative physiology approach we are comprehensively assessing the role of renalase in in relevant tissues, some of which have been first described by us to express renalase.
Effects of endoscopic thoracic sympathectomy for facial and palmar hyperhidrosis on blood pressure and muscle/skin sympathetic nerve activity
Group leaders: Ms Toni McGee and Ms Erika Camara
Hyperhidrosis is characterized by abnormally increased sweating that can be successfully treated by endoscopic thoracic sympathectomy. Since these nerves are also significantly involved in control of blood pressure and heart function we are exploring the effects of the surgery on blood pressure and muscle sympathetic nerve activity.
Endoscopic sympthetic denervation using endoclips at the level of T2 and T3.
