Allan Struthers

Personal profile

Biography

Allan Struthers graduated MB (Hons) from Glasgow University UK in 1977. After junior hospital posts in Glasgow, he was Senior Registrar at the Royal Postgraduate Medical School and Hammersmith Hospital in London in 1982 – 1985.

He was then appointed Wellcome Senior Lecturer/Consultant Physician in Dundee and is currently Professor of Cardiovascular Medicine and runs the Heart Failure service at Ninewells Hospital in Dundee. He is also an Honorary Professor at St Andrews University Medical School. He was Chairman of the SIGN Guidelines in Heart Failure twice (2007 and 2016) and Chairman of NHS-QIS Standards (2010) for Heart Failure. In addition, he is also Chairman of Tenovus NSAC, Senior Regional Advisor for SACDA and a Council member of Chest, Heart and Stroke (Scotland).

He is currently Co-Head of the Division of Molecular and Clinical Medicine at the University of Dundee. Professor Struthers runs a large clinical research programme and has supervised 50 MD/PhDs.

He helped pioneer the use of plasma BNP to identify heart failure patients and the use of aldosterone blockers to reduce their mortality.

Another research interest is in allopurinol and he has recently shown it to have antianginal oxygen sparing effects and to regress LV hypertrophy. He is currently funded (as PI) by the BHF, MRC, CSO, Diabetes (UK) and Chest, Heart & Stroke.

In total he has held 38 different British Heart Foundation (BHF) grants. He has published 508 papers which are cited around 600 times every year. His research “h” factor is high at 60. He is a Fellow of the European Society of Cardiology (FESC), the Royal Society of Edinburgh (FRSE) and the Academy of Medical Sciences (FMed Sci).

He teaches Cardiovascular Medicine and Therapeutics at both the University of Dundee and the University of St Andrews Medical School.

He has given 207 invited lectures, half abroad.

Research

Professor Struthers has repeatedly spotted new therapeutic opportunities and conducted the initial “proof of concept” studies which, led to confirmation in larger trials. For example, he was the first to ever show that aldosterone blockade had beneficial cardiac effects in man on top of ACE inhibitors (Am J Card 1995, 76: 1259): those effects were to reduce both ventricular arrhythmias and cardiac sympathetic activity. The discovery helped lead to the RALES trial where spironolactone reduced mortality in heart failure (HF) by 30%. He also discovered other mechanisms contributing to aldosterone’s ability to increase cardiac deaths, i.e. it decreases endothelial nitric oxide, it decreases cardiac autonomic function and it increases plasma collagen markers (which are a good surrogate for myocardial fibrosis).

A second area where he made important original discoveries is B-type natriuretic peptide (BNP). He wrote one of the two original studies published together in the Lancet (1993) which led to the use of plasma BNP levels to identify heart failure (HF). A later paper by him, also in the Lancet, confirmed this. BNP is now an integral part of all HF guidelines. Professor Struthers has now moved on to make original observations about BNP in a completely new (non HF) area. He has recently discovered that if an apparently healthy individual has a high BNP level, this often signifies that they have silent coronary artery disease (Heart 2006, 92: 487 and 916). This is a major finding as BNP screening could now be used to help identify those many apparently healthy middle aged individuals whose first ever manifestation of their previously silent coronary disease is sudden cardiac death.

A whole other area pioneered by him is allopurinol. He developed the novel idea that allopurinol could be “oxygen in a pill” because it inhibits an oxidase enzyme which normally “wastes” oxygen in ischaemic tissue. A recent Lancet paper (2010, 375: 2161 – 7) showing this could lead eventually to the use of allopurinol as an oxygen sparing agent in all ischaemic diseases. He had already unravelled the exact mechanism whereby allopurinol improves endothelial function by profoundly reducing vascular oxidative stress and not at all by decreasing uric acid. This was a much debated issue before his elegant paper in Circulation settled the issue.

Lastly, he had the original idea behind another paper of major therapeutic importance. In conjunction with Professor McMurdo, he showed that ACE inhibitors improve mobility in elderly, disabled, immobile patients, which should greatly improve the quality of life of many elderly patients. In fact, this paper won the Bruce P Squires award as one of the best in the year. If confirmed, ACE inhibitors could become the equivalent of “exercise in a pill” to the many elderly with limited mobility.

Teaching

He teaches Cardiovascular Medicine and Therapeutics at both the University of Dundee and the University of St Andrews Medical School.

Education/Academic qualification

Bachelor of Medicine and Bachelor of Surgery, University of Glasgow

Award Date: 1 Jan 1977

Bachelor of Science, University of Glasgow

Award Date: 1 Jan 1973

Keywords

RM Therapeutics. Pharmacology
Cardiovascular

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Projects

2 Not started
5 Active
18 Finished

Evaluation of the Clinical Efficacy of Texture Analysis in Myocardial Quantification

Houston, G. & Struthers, A.

1/09/17 → 31/08/21

Project: Research

Cardiovascular Research: From Biomarkers to Clinical DATA, TICR 2017

Anderson, A., Belch, J., Choy, A., George, J., Houston, G., Khan, F., Lang, C. & Struthers, A.

The Institute of Cardiovascular Research

1/07/17 → 30/06/20

Project: Research

Leucine and ACE Inhibitors as Therapies for Sarcopenia; a Two by Two Factorial Randomised Placebo Controlled Trial (Joint with NHS Tayside, Imperial College London and University of Aberdeen)

Donnan, P., George, J., McMurdo, M., Struthers, A., Sumukadas, D. & Witham, M.

1/11/15 → 30/06/20

Project: Research

Allopurinol and Cardiovascular Outcomes in Patients with Ischaemic Heart Disease (Joint with Robertson Centre for Biostatistics, University of Nottingham and University College London)

MacDonald, T., Mackenzie, I. & Struthers, A.

National Institute for Health Research

1/09/13 → 1/04/21

Project: Research

TICR Research: A Multidisciplinary Approach to Cardiovascular Disease

Anderson, A., Belch, J., Choy, A., Houston, G., Khan, F., Lang, C., Palmer, C. & Struthers, A.

The Institute of Cardiovascular Research

2/05/13 → 1/08/20

Project: Research

Research Output

20544 Citations
74 h-Index
475 Article
45 Book/Film/Article review
34 Letter
26 Meeting abstract
30 More

Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial

Singh, J. S. S., Mordi, I. R., Vickneson, K., Fathi, A., Donnan, P. T., Mohan, M., Choy, A. M. J., Gandy, S., George, J., Khan, F., Pearson, E. R., Houston, J. G., Struthers, A. D. & Lang, C. C., 3 Apr 2020, In : Diabetes Care. dc192187.

Research output: Contribution to journal › Article

Open Access

File

Reply

Gingles, C. R., Symon, R., Gandy, S. J., Struthers, A. D., Houston, G., MacDonald, T. M., Lang, C. C., Donnan, P. T. & George, J., 1 Jan 2020, In : Journal of Hypertension. 38, 1, p. 177-178 2 p.

Research output: Contribution to journal › Letter

Allopurinol treatment adversely impacts left ventricular mass regression in patients with well-controlled hypertension

Gingles, C., Symon, R., Gandy, S., Struthers, A., Houston, G., MacDonald, T., Lang, C., Donnan, P. & George, J., Dec 2019, In : Journal of Hypertension. 37, 12, p. 2481-2489 9 p.

Research output: Contribution to journal › Article

Open Access

File

3 Citations (Scopus)

121 Downloads (Pure)

A Randomized Controlled Trial of Metformin on Left Ventricular Hypertrophy in Patients with Coronary Artery Disease without Diabetes: The MET-REMODEL Trial

Mohan, M., Al-Talabany, S., McKinnie, A., Mordi, I., Singh, J., Gandy, S., Baig, F., Hussain, M. S. ., Bhalraam, U., Khan, F., Choy, A., Matthew, S., Houston, G., Struthers, A., George, J. & Lang, C. C., 1 Nov 2019, In : European Heart Journal. 40, 41, p. 3409-3417 9 p.

Research output: Contribution to journal › Article

Open Access

File

12 Citations (Scopus)

79 Downloads (Pure)

Cardiovascular Effects of Switching from Tobacco Cigarettes to Electronic Cigarettes

George, J., Hussain, M., Vadiveloo, T., Ireland, S., Hopkinson, P., Struthers, A. D., Donnan, P. T., Khan, F. & Lang, C. C., 15 Nov 2019, In : Journal of the American College of Cardiology. 9 p.

Research output: Contribution to journal › Article

Open Access

File

9 Citations (Scopus)

47 Downloads (Pure)

Activities

2 Participation in conference

British Geriatrics Society Spring Meeting

Allan D. Struthers (Participant)

2 Apr 2009

Activity: Participating in or organising an event types › Participation in conference

19th Annual Conference of the European Health Psychology Society. Enhancing Individual, Family & Community Health

Allan D. Struthers (Participant)

2 Sep 2005

Activity: Participating in or organising an event types › Participation in conference

Press / Media

High Dose Allopurinol Reduces Left Ventricular Mass In Patients With Ischemic heart Disease

Sushma Rekhraj, Stephen J. Gandy, Benjamin Szwejkowski, Adnan Nadir, Awsan Noman, J. Graeme Houston, Chim C. Lang, Jacob George & Allan D. Struthers

5/03/13

1 item of Media coverage

Press/Media: Research

Blood tests pick up early 'silent' heart disease

Adnan Nadir, Sushma Rekhraj, Li Wei, Tiong Lim, John Davidson, Thomas M MacDonald, Chim C. Lang, Eleanor Dow & Allan D. Struthers

24/09/12

1 item of Media coverage

Press/Media: Research