Shop-to-Stop Hypertension: A public screening campaign to detect and manage raised blood pressure in Australian adults
Background
Worldwide the leading risk factor for death is raised blood pressure (BP), accounting for ~30,000 deaths daily.1 In Australia, high BP is responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter and 3.6% of dementia.2 Better BP control could save more lives than any other single treatment intervention.3 In Australia, BP control rates have stagnated since 2011 at ~32%,4, 5 leading to a 2022 call to action to improve uncontrolled BP in Australia.5
Hypertension (the condition you have from high BP) is called the "silent killer" because most people who have raised BP do not have any symptoms.6 In Australia, 34% of adults have hypertension,4 but millions remain unaware and undiagnosed.6, 7 Only one in two people detected to have high BP are aware of their condition.8 Innovative strategies to target wider and high-risk populations,
PREVENTion with SGLT-2 inhibition of Acute Kidney Injury in intensive care (PREVENTS-AKI)
Background
Acute Kidney Injury (AKI) affects up to 1 in 2 patients treated in the ICU, and is associated with poorer survival, reductions in long term kidney function and greater cost of treatment. There are no treatments proven to reduce these impacts of AKI but there is a growing evidence base suggesting that inhibitors of the sodium-glucose transport protein 2 (SGLT-2 inhibitors) in the kidney tubule may protect against AKI.
SGLT-2 inhibitors were originally developed as a treatment for type 2 diabetes but have been proven in recent clinical trials to significantly improve outcomes for patients with heart disease and/or kidney impairment - with fewer patients progressing to dialysis, needing hospital care or dying. Later examination of these trials has also shown lower rates of AKI in participants receiving SGLT-2 treatment but, as these results were not the main outcome of the studies, these findings are not enough to change patient treatment.
Aim
To conduct a prospective, multi-centre, parall
The wider benefits of SGLT2 inhibitors
Policy & Practice Report
Triple therapy prevention of Recurrent Intracerebral Disease EveNts Trial (TRIDENT)
Current status– finished recruitment – in follow-up.TRIDENT is an international medical research study which aims to determine the effect of more intensive blood pressure control to prevent recurrent stroke in patients who have had an intracerebral haemorrhage (ICH) (a stroke caused by ruptured blood vessel in the brain). The aim of this project is to test the superiority of a fixed low-dose combination blood pressure-lowering pill (Triple Pill) strategy in recurrent stroke in patients with a history of ICH.Acute ICH accounts for at least 10% of the 20 million new strokes in the world each year. ICH survivors are at high risk of recurrent stroke and other serious cardiovascular events. Numerous studies have proven the benefit of stroke survivors reducing their risk of recurrent stroke through taking blood pressure-lowering medications. However, studies have shown that many ICH survivors are either not receiving any blood pressure-lowering medication or they are receiving inadequate control.The TRIDENT stu
The TReAT trial: Mobile application for rehabilitation support after knee replacement
Background
Knee replacement improves the quality of life for those suffering from disabling knee osteoarthritis. Physiotherapy is an important component of the rehabilitation phase following surgery for restoring function and improving quality of life. However, poor adherence to physical therapy due to various socio-environmental and patient-related factors delays recovery. A lack of mechanism for the continuum of care following discharge to home leads to sub-optimal outcomes, chronic knee pain and patient dissatisfaction in some proportions of individuals.
Evidence suggests that home-based physical rehabilitation with a monitoring mechanism is as good as and cost-effective compared to clinic-based rehabilitation. In India, unsupervised home-based rehabilitation is the usual care, leading to a considerable amount of out-of-pocket expenditure to seek physiotherapist support at home. Hence, keeping the local requirements and literacy level in mind, a customised and context-specific rehabilitation monitori
REVERSE: Reducing cardiovascular and kidney risk in diabetes
Background
Diabetes is a major public health challenge, causing additional complications across multiple organ systems. Cardiovascular disease (CVD) and chronic kidney disease (CKD) are the leading causes of disability and death in people with type 2 diabetes mellitus (T2DM).
In Australia, T2DM prevalence has nearly tripled in recent decades, with around 1.3 million people affected. The condition carries enormous economic and societal costs. T2DM has a major impact in socioeconomically disadvantaged areas like Western Sydney, South-Western Sydney, and regional NSW, where high prevalence and CVD/CKD complications represent major challenges for local health services.
Treatments to slow and prevent the CVD/CKD effects of diabetes exist, but they rely on a health system that can readily identify high-risk patients, implement, and monitor treatment, and coordinate the complex care of such patients. Although proven strategies to delay and prevent the impacts of CVD and CKD in high-risk diabet
Assessment of absolute cardiovascular disease risk
Policy & Practice Report
Evidence library
Please find below a list of the key publications supporting the case for potassium-enriched salt. For a more comprehensive list, click here or to return to the main page click here.
Trials
Effect of Salt Substitution on Cardiovascular Events and Death.New England Journal of Medicine, 2021https://www.nejm.org/doi/full/10.1056/nejmoa2105675
Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial.Nature Medicine, 2023https://www.nature.com/articles/s41591-023-02286-8
Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis.Heart 2022https://heart.bmj.com/content/108/20/1608.long
Effects of a reduced-sodium added-potassium salt substitute on blood pressure in rural Indian hypertensive patients: a randomized, double-blind, controlled trialThe American Journal of Clinical Nutrition, 2021https://www.sciencedirect.com/science/article/pii/S0002916522003185
A guide to potassium-enriched salt
Please find below downloadable one-page guides for consumers and health professionals with key information on potassium-enriched salt.
For health professionalsA guide to potassium-enriched salt.Learn more
For consumersA guide to potassium-enriched salt.Learn more
WHO guidelineA summary for policy makersLearn more
FactsheetSwitching the world’s salt supply: Scaling up the use of potassium-enriched salt.Learn more
For meal producersLearn more
EvidenceUK evidence on using low-sodium salt substitutes.Learn more
Why do we need to #SwitchTheSalt?
Why do we need to #SwitchTheSalt?
Almost everyone eats salt and almost everyone eats too much of it. Eating too much salt increases blood pressure, leading to heart attacks, strokes and deaths. Despite the efforts by governments and medical organisations over the last decade to reduce population salt intakes, little progress has been made. This is because people have become accustomed to the taste and dietary habits are hard to change. Salt is also a widely used ingredient in food manufacturing, and progress towards lowering levels in packaged foods has been slow.
Find out more about our work to scale up the use of potassium-enriched salt across the global food supply.
What is potassium-enriched salt?
Potassium-enriched salt is a practical and scalable approach to lowering blood pressure and with it, the risk of strokes, heart attacks and death. Salt is made up of 100% sodium and chloride. A potassium-enriched salt, however, has some of the harmful sodium chloride replaced wi
Gender-responsive Research and Advocacy through CEDAW (GRACE) in India, Indonesia, South Africa, and Kenya
Background
Women who have survived violence experience negative consequences on their sexual and reproductive health, unsafe abortions, sexually transmitted infections, traumatic fistulas, and are twice as likely to be diagnosed with cervical cancer. They also experience anxiety, depression, and alcohol use disorders. Rates of violence against women and gender based discrimination continue to remain high despite legislative action by governments. With COVID-19 pandemic, the situation has become alarming demanding ever more serious action in protecting the rights of women and addressing Gender Based Violence (GBV) and discrimination across the globe.
The United Nations (UN) Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) has been considered as an important instrument towards encouraging governments to take action towards protecting the rights of women and addressing gender based discrimination through legal reforms. It has been 40 years since the United Nations (UN) Con
Health Star Rating system
Policy & Practice Report