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The William Harvey Research Institute - Barts and The London

Dr Ajay K Gupta

Ajay K

Senior Clinical Lecture & Hon. Consultant inClinical Pharmacology and Cardiovascular & Internal Medicine

Centre: Clinical Pharmacology

Email: ajay.gupta@qmul.ac.uk
Telephone: +44(0)20 7882 2858

Profile

ORCID iD: https://orcid.org/0000-0001-5807-8503

Ajay graduated in medicine (MBBS) with distinction in Pharmacology, and completed his initial core medical training (MD) from Delhi University. Subsequently, Ajay won a prestigious World Bank Scholarship award to do Master of Science (MSc) in epidemiology from London School of Hygiene and Tropical Medicine (University of London). After that, he did his PhD under the supervision of Profs Neil Poulter and Peter Sever from Imperial College, London. He completed his further specialist clinical training in General Internal Medicine and Clinical Pharmacology and Therapeutics from Royal London and St Bartholomew Hospital.

Ajay’s research to date has been in a broader field of preventive cardiovascular and metabolic medicine with a particular focus on hypertension, statin therapy, and diabetes. He has extensive experience of population health research, clinical trials design and management, and has been associated with several large phase-3 clinical trials, such as ASCOT. He has been on the end-point and adjudication committees of a few clinical trials and studies, such as PREMIUM, SABRE, and ORBITA.  When working in Imperial College, he gained substantial experience in analyses of large databases. Another research interest of Ajay is on reporting of drug-related adverse events in trials, and how are they captured in databases.

Recently, he has been involved in setting up a large cohort study - the ASCOT Legacy cohort.  Another research focus of Ajay is in the area related to the ethnic differences in the treatment response and the influence of ethnicity on cardiovascular outcomes, particularly amongst South Asian and Asian populations. Ajay also has extensive experience in doing meta-analyses and systematic reviews. He is interested in developing research programmes to inform clinical practice and generate hypothesis; by either utilising previously published data in various trials, studies and surveys or from developing various linkages with the administrative databases. He has been a member of editorial board of several journals and is a Senior Associate Editor of Journal of American Heart Association.

Clinically, Ajay works as Hon consultant in the Barts BP Centre of Excellence at Barts Heart Centre. He has a clinical interest in managing complex patients with multiple cardiovascular risk factors, including hypertension, diabetes and obesity. He works with patients with drug intolerance, and those with drug-related adverse effects, to help develop different strategies to manage their risk. In the past, he has been instrumental in developing clinical pathways, for example, he was instrumental in developing an ambulatory care clinic setup and setting up a secondary care diabetes clinic.  In the past, he has extensively worked in several other sub-specialties, including Acute Medicine and Diabetes and Endocrinology, and has thus gained wide-based clinical experience in different specialities.

Academic Awards

  • Finalist American Society of Hypertension 2008 Young Investigator Award
  • Finalist Austin Doyle Award, International Society of Hypertension Conference, 2006
  • Joint Japan World Bank Graduate Scholarship, 2003–4 for study in LSHTM, University of London
  • Asian Development Bank Scholarship, 2003, University of Sydney
  • 35th World Heart Federation Fellowship 2001

Research

Group members

Barts Cardiovascular CTU: Prof Amrita Ahluwalia (Interim Chair), Dr Vivienne Monk (Manager), Dr Saidi Mohiddin, Prof Steffen Peterson, Dr Dan Jones (Senior Lecturer), Jane Field 

Members of Blood Pressure Group: Dr Mel Lobo, Dr Vikas Kapil, Dr Fu Ng, Dr Gurvinder Rull, Dr David Collier, Dr Manish Saxena, Dr Peter Julu, Dr Chris Wolff, Mr Sotiris Antoniou

Cardiovascular Genomics: Prof Mark Caulfield, Prof Patricia Munroe, Prof Moris Brown, Dr Fu Ng, Dr Helen Warren, Dr Claudia Cabrera, Dr Mike Barnes

Summary 

Dr Gupta’s research interests are mainly around the epidemiology and therapeutics related to the cardiovascular and metabolic medicine; the treatment and pathophysiology of hypertension, impact of statin therapy, and prevention of the cardiovascular events amongst those with diabetes. He has a particular interest in developing risk prediction models to help prevent major cardiovascular adverse events. He has worked extensively in evaluating the efficacy and utility of various newer and older antihypertensive agents. Ajay’s other research focus is in the area related to the ethnic differences in treatment response, and the relationship of the ethnicity with cardiovascular risk factors and diseases. In his research, he utilises the information available in the existing databases to develop evaluations that may, in turn, help improve the understanding about some of the less explored (but clinically significant) issues in the field of cardiovascular and metabolic medicine. For example, in the past, he has done several meta-analyses to answer clinically relevant questions. He has also used large clinical trial databases to generate evidence, which in turn has improved clinical practice and have generated the newer hypothesis. He aims to develop a portfolio of such research programme that can deliver tangible research outputs at significantly lower costs. 

ASCOT legacy cohort, and LATER dementia programme: Ajay is a part of the study team for the two ongoing cohort studies that are developed from the patients who were initially randomised in the Anglo-Scandinavian Cardiac Outcomes Trial. This a cohort of 8600 hypertensive patients, who were initially followed up for 5.5 years as part of the original ASCOT trial, and after that, they are being followed for morbidity and mortality using various database linkages.  In LATER Dementia project, the impact of blood pressure and lipid-lowering during mid-life is being examined for the subsequent development of cognitive impairment.

Other ongoing research projects:

  • Impact of BP control and BP variability on long-term morbidity and mortality.
  • To evaluate the role of drug-related new-onset diabetes on cardiovascular morbidity and mortality
  • To evaluate the relationship of pulse pressure in comparison to systolic blood pressure as the marker of the future cardiovascular risk

Key Publications

  • Gupta A, Mackay J, Whitehouse A, et al. Long-term mortality after blood pressure-lowering and lipid-lowering treatment in patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes (ASCOT) Legacy study: 16 year follow-up results of a randomized factorial trial. Lancet,2018: epub https://doi.org/10.1016/S0140-6736(18)31776-8
  • Gupta, A.K., Hypertensive Disorders in Pregnancy and the Risk of Cardiovascular Disease: A Need for Postpartum Strategies for the Primary Prevention. J Am Heart Assoc, 2018. 7(10).
  • McGlone ER, Gupta, AK, Reddy, M et al: Antral resection versus antral preservation during laparoscopic sleeve gastrectomy for severe obesity: systematic review and metaanalysis. Surgery for Obesity and Related Diseases, 2018: 14(6):857-64
  • Gupta A, Thompson D, Whitehouse A et al. Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian Cardiac Outcomes Trial – Lipid-Lowering Arm (ASCOT-LLA). Lancet, 2017, 389: 2473-81
  • Marcano-Belisario JS, Gupta AK, O’Donoghue J, et al. Implementation of depression screening in antenatal clinics through tablet computers: results of a feasibility study. BMC Medical Informatics and Decision Making, 2017, May. Volume: Article: 59
  • Prieto-Merino D; Dobson J; Gupta AK et al. “ASCORE: an up-to-date cardiovascular risk score for hypertensive patients reflecting contemporary clinical practice developed using the (ASCOT-BPLA) trial data.” J Hum Hypertens.2013 10.1038/jhh.2013.3.
  • Elley CR; Gupta AK; et al. “The Efficacy and Tolerability of ‘Polypills’: Meta-Analysis of Randomised Controlled Trials.” PLoS ONE. 2012 Vol 7:12: e52145.
  • Sever PS; Chang CL; Prescott MF; Gupta A et al. (Dec 2012). “Is plasma renin activity a biomarker for the prediction of renal and cardiovascular outcomes in treated hypertensive patients? Observations from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT).” Eur Heart J. 33:2970-2979.
  • Gupta AK. “The efficacy and cost-effectiveness of statins in low-risk patients.” 2011 Epub Oct 24. http://www.cmaj.ca/content/early/2011/10/24/cmaj.111674.long
  • Sever PS; Chang CL; Gupta AK; Whitehouse A; Poulter NR. “The Anglo-Scandinavian Cardiac Outcomes Trial: 11-year mortality follow-up of the lipid-lowering arm in the UK.” Eur Heart J. 2011 Oct;32(20):2525-32.
  • Gupta AK; Nasothimiou EG; Chang CL; Sever PS; Dahlof B; Poulter NR. “Baseline predictors of resistant hypertension in the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT): a risk score to identify those at high-risk. J Hypertens. 2011 Oct;29(10):2004-13.
  • Gupta AK; Prieto-Merino D; Dahlöf B; Sever PS; Poulter NR, on behalf of the AI. “Metabolic syndrome, impaired fasting glucose and obesity, as predictors of incident diabetes in 14120 hypertensive patients of ASCOT-BPLA: comparison of their relative predictability using a novel approach.” Diabet Med. 2011;28(8):941–7.
  • Bangalore S; Kumar S; Kjeldsen SE; Makani H; Grossman E; Wetterslev J; Gupta AK et al. “Antihypertensive drugs and risk of cancer: network meta-analyses and trial sequential analyses of 324[punctuation space]168 participants from randomised trials.” The Lancet Oncology. 2011;12(1):65–82.
  • Gupta AK; Poulter NR; Dobson J; Eldridge S; Cappuccio FP; Caulfield M, et al. “Ethnic differences in blood pressure response to first and second-line antihypertensive therapies in patients randomized in the ASCOT Trial”. Am J Hypertens. 2010 Sep;23(9):1023–30.
  • Gupta AK; Dahlof B; Sever PS; Poulter NR. “Metabolic syndrome, independent of its components, is a risk factor for stroke and death but not for coronary heart disease among hypertensive patients in the ASCOT-BPLA.” Diabetes Care. 2010 Jul;33(7):1647–51.
  • Gupta AK; Arshad S; Poulter NR. “Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010 Feb;55(2):399–407.
  • Gupta AK; Dahlof B; Dobson J; Sever PS; Wedel H; Poulter NR. “Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm and the relative influence of antihypertensive medication.” Diabetes Care. 2008 May;31(5):982–8.

Sponsors

Collaborators

Internal

External

  • Peter Sever (Imperial)
  • Neil Poulter (Imperial Clinical Trials Unit)
  • Timothy Collier (LSHTM)
  • Teck Khong (St George’s)
  • Neil Chapman (St Mary’s)