Projects per year
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.
He teaches Cardiovascular Medicine and Therapeutics at both the University of Dundee and the University of St Andrews Medical School.
Expertise related to UN SDGs
In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. This person’s work contributes towards the following SDG(s):
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
- RM Therapeutics. Pharmacology
1/09/17 → 31/08/21
Allopurinol and Cardiovascular Outcomes in Patients with Ischaemic Heart Disease (Joint with Robertson Centre for Biostatistics, University of Nottingham and University College London)
1/09/13 → 31/03/22
Aref#d: 19604. The TASCFORCE Project: Tayside Screening for Risk of Cardiac Events and the Effect of Statin on Risk Reduction (as Evidenced by Change in LV Mass)
1/06/07 → 31/12/23
A Randomized Controlled Trial of the Effect of Allopurinol on Left Ventricular Mass Index in Hemodialysis PatientsRutherford, E., Ireland, S., Mangion, K., Stewart, G. A., MacGregor, M. S., Roditi, G., Woodward, R., Gandy, S. J., Houston, J. G., Jardine, A. G., Rauchhaus, P., Witham, M., Mark, P. B. & Struthers, A. D., 1 Jan 2021, In: Kidney International Reports. 6, 1, p. 146-155 10 p.
Research output: Contribution to journal › Article › peer-reviewOpen AccessFile8 Downloads (Pure)
Association between mitochondrial function measured by 31P Magnetic Resonance Spectroscopy and physical performance in older people with functional impairmentChungath, R. R., Witham, M. D., Clarke, C. L., Hutcheon, A., Gandy, S., Gingles, C., Priba, L., Nicholas, S. R., Cavin, I., Sumukadas, D., Struthers, A. D. & George, J., 5 May 2021, (E-pub ahead of print) In: JCSM Clinical Reports.
Research output: Contribution to journal › Article › peer-review
Dapagliflozin Improves Left Ventricular Myocardial Longitudinal Function in Patients with Type 2 Diabetes: Echocardiographic Substudy of the DAPA-LVH TrialBrown, A., Gandy, S., Mordi, I. R., McCrimmon, R., Ramkumar, P. G., Houston, J. G., Struthers, A. D. & Lang, C. C., 1 Feb 2021, In: JACC: Cardiovascular Imaging. 14, 2, p. 503-504 2 p.
Research output: Contribution to journal › Letter › peer-review
Lipworth, B. J., Weir-McCall, J. R., Houston, J. G. & Struthers, A. D., 25 Aug 2020, In: International Journal of Chronic Obstructive Pulmonary Disease. 2020, 15, p. 2015-2024 10 p.
Research output: Contribution to journal › Article › peer-reviewOpen AccessFile14 Downloads (Pure)
A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type two diabetes: The DAPA-LVH TrialBrown, A. J. M., Gandy, S., McCrimmon, R., Houston, J. G., Struthers, A. D. & Lang, C. C., 21 Sep 2020, In: European Heart Journal. 41, 36, p. 3421-3432 12 p.
Research output: Contribution to journal › Article › peer-reviewOpen AccessFile19 Citations (Scopus)36 Downloads (Pure)
Struthers, Allan (Recipient), 2011
Prize: National/international honour
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
1 item of Media coverage