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Open Access Biomedical Publisher Using Post Publication Peer Review
Associate Professor, Clinical Research, Pennington Biomedical Research Center, Louisiana State University System United States of America 70808
As a practicing Family Medicine physician for over 30 years (both in India and here in the United States), Dr. Gupta has developed a keen interest in primary prevention of disease. He has been focusing upon preclinical precursors (prediabetes and prehypertension) for the most common chronic diseases (diabetes mellitus and hypertension).
With the use of non-invasive 7-day automatic ambulatory blood pressure monitoring he has discovered that prediabetes is associated with circadian blood pressure variability abnormalities. He has also found that otherwise healthy obese subjects that had normal fasting serum glucose and mild elevation of systemic inflammation had normal circadian blood pressure variability and endothelial function, while those healthy obese that had prediabetes (fasting serum glucose 100-125 mg/dL) and a significantly exacerbated systemic inflammation, had abnormal circadian blood pressure variability and endothelial dysfunction. He has elucidated the prevalence of prediabetes (26.8%), prehypertension (36.3%) and co-existing prediabetes and prehypertension (11.2%) in healthy adult population (NHANES 1999-2006) in the United States.
That means that one in three healthy adults has prehypertension, one in four has prediabetes and one in ten has both prehypertension and prediabetes. Over 30% of individuals with prehypertension deteriorate into hypertension, while about 20% of healthy adults with prediabetes are diagnosed with diabetes in 4 years.
Given the high prevalence of these pre-disease states, which are also associated with an increased risk for accelerated adverse cardiovascular events, urgent preventive measures to combat high conversion rates from pre-disease to overt chronic disease conditions are required.
He has also recently shown that high-glycemic high-fat diet in rats increases fasting blood sugar and also results in abnormal blood pressure variability. He was also able to show this to occur in human volunteers: who along with the weight gain with a mere 8 weeks of overfeeding, showed an increase in waist circumference (“bad central fat”), fasting glucose (prediabetes) and resting blood pressure (prehypertension). These volunteers, in addition to this, compared to their own pre-overfeeding circadian blood pressure variability and resting endothelial function, did exhibit significant abnormalities of circadian blood pressure variability and resting endothelial function.
With the use of novel, non-invasive methodologies (automatic 7-day ambulatory blood pressure monitoring and resting endothelial function testing) in healthy high risk individuals he is working to establish a cause and effect relationship between prediabetes (central adiposity, exacerbated systemic inflammation, dyslipidemia and elevated cardiac risk ratios) and circadian blood pressure and endothelial function abnormalities. This will help with the first steps in the design of meaningful preventive measures for primary prevention of chronic disease.
Professional Experience:
Associate Professor, Research.
Pennington Biomedical Research Center, Baton Rouge, LA. 2011 - Present.
Medical Director,
Cannon Hospice, Baton Rouge, LA. 2004 - Present.
Assistant Professor, Research.
Pennington Biomedical Research Center, Baton Rouge, LA. 2003 - 2011.
Staff Physician, Department of Internal Medicine/Family Practice,
Stanocola Medical Clinic, Baton Rouge, LA. 1996 - Present.
Faculty, Graduate Medical Education,
General Health System, Baton Rouge, LA. 1994 - Present.
Staff Physician, Department of Family Medicine,
Ochsner Clinic of Baton Rouge, Baton Rouge, LA. 1993 - 1996.
Post Graduate Researcher/Research fellow,
Cholesterol Center, VA Medical Center, Long Beach/UCI, Irvine, CA. 1988 - 1990.
Specialized Referral Clinic for Management of Dyslipoprotenemias,
UCI, Irvine, CA. 1988 - 1990.
Research Assistant,
Division of Infectious Diseases, Department of Internal Medicine,
Charles R. Drew University/UCLA Las Angeles, CA. 1986 - 1988.
Solo Family Practice, Hyderabad, Andhra Pradesh, India. 1980 - 1985.
Personal Statement
As a practicing Family Medicine physician for over 30 years (both inIndiaand here in theUnited States), I have developed a keen interest in primary prevention of disease. I have been focusing upon preclinical precursors (prediabetes, prehypertension) for the most common chronic diseases (diabetes mellitus and hypertension). With the use of non-invasive 7-day automatic ambulatory blood pressure monitoring we discovered that prediabetes is associated with circadian blood pressure variability abnormalities. We also found that otherwise healthy obese subjects that had normal fasting serum glucose (and mild elevation of systemic inflammation) had normal circadian blood pressure variability and endothelial function, while those healthy obese that had prediabetes (fasting serum glucose 100-125 mg/dL) and a significantly exacerbated systemic inflammation, had abnormal circadian blood pressure variability and endothelial dysfunction. We have elucidated the prevalence of prediabetes (26.8%), prehypertension (36.3%) and co-existing prediabetes and prehypertension (11.2%) in healthy adult population (NHANES 1999-2006) in theUnited States. Given the high prevalence of these pre-disease states, which are also associated with an increased risk for accelerated adverse cardiovascular events, urgent preventive measures to combat high conversion rates from pre-disease to overt chronic disease conditions are required. This study with the use novel, non-invasive methodologies (automatic 7-day ambulatory blood pressure monitoring and resting endothelial function) in healthy high risk individuals will help establish a cause and effect relationship between prediabetes (central adiposity, exacerbated systemic inflammation, dyslipidemia and elevated cardiac risk ratios) and circadian blood pressure and endothelial function abnormalities. This will help with the first steps in the design of meaningful preventive measures for primary prevention of chronic disease.
C. Selected Peer-Reviewed Publications (from 76)
1. Esposito S, Gupta A, Thadepalli H. In-vitro Synergy of Ciprofloxacin and three other antibiotics against Bacteroides fragiles. Drug Exp. Clinical Research; XIII (8): 489-492-1987.
2. Gollapudi SVS, Gupta A, Thadepalli H. Perez A: Use of Lymphokines in Treatment of Experimental Intra-abdominal Abscess caused by Bacteroides fragiles. Infection and Immunity: 56 (9): 2369-72-1988.
3. Gollapudi SVS, Gupta A, Thadepalli H, Perez A: Use of Lympkhokines in Treatment of Experimental Intra-Abdominal Abscess caused by Bacteroides fragiles. Research Resources Reporter, Vol. XIII, 10. A Publication by US National Institute of Health Research Resources. A Special Mention.
4. Amarasuriya RN, Gupta AK, Civen M, Horng YC, Maeda T, Kashyap ML. Ethanol Stimulates Apolipoprotein A-1 Secretion By Human Hepatocytes: Implications for a Mechanism for Atherosclerosis Protection. Metabolism. 1992 Aug; 41(8):827-32.
5. Gupta AK, Ross EA, Myers JN, Kashyap ML. Increased Reverse Cholesterol Transport in Athletes. Metabolism. 1993 Jun; 42(6):684-90.
6. Selam JL, Kashyap ML, Gupta AK, Turner D, Wong ND, Lozano JL, Charles MA. Alterations in Reverse Cholesterol Transport associated with Programmable Implantable Intraperitoneal Insulin Delivery. Metabolism, 1994 Jun; 43(6):665-9. Am J Hypertens. 1996 Apr;9(4 Pt 1):342-60.
7. The ALLHAT Officers and the Coordinators for the ALLHAT Collaborative Research Group. Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs. Diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002 Dec 18; 288(23):2981-97. Erratum in: JAMA 2003 Jan 8; 289(2):178. JAMA. 2004 May 12; 291(18):2196. JAMA, Vol. 288, No.23, Dec 2002 :pp 2981-2997.
8. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major Outcomes in Moderately Hypercholesterolemic, Hypertensive Patients Randomized to Pravastatin vs. Usual Care. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA. 2002 Dec 18; 288(23):2998-3007: JAMA, Vol. 288, No.23, (December) 2003: pp 2998-3007.
9. Carl J. Pepine, M.D., Elieen M. Handberg, PhD, et al for the INVEST Investigators. A Calcium Antagonist vs. a Non-Calcium Antagonist Hypertension Treatment Strategy for Patients With Coronary Artery Disease. The International Verapramil-Trandolapril Study (INVEST): A Randomized Controlled Trial. JAMA; Vol.290 No.21 December 2003; pp2805-281.
10. Greenway FL, Liu Z, Yu Y, Caruso MK, Roberts AT, Lyons J, Schwimmer JE, Gupta AK,
Bellanger DE, Guillot TS, Woltering EA. An assay to measure angiogenesis in human fat tissue.
Obes Surg. 2007 Apr; 17(4):510-5.
Gupta AK, O'Neil P, Schumacher D, Smith D, Dunayevich E, Tollefson GD, Weber E, Cowley MA. Rational Design of a Combination Medication for the Treatment of Obesity. Obesity (Silver Spring). 2009 Jan; 17(1):30-9. Epub 2008 Nov 6.
I think that this it is an excellent idea. It would help promote scientific knowledge in an unencumbered fashion.