Ble, Alessandro - University of Exeter

个人简介

Alessandro’s current research programme aims to help improve the health and well being of older people. In the “big data” era, very-large datasets of electronic medical records are becoming available for medical research. Alessandro’s research programme is exploiting this opportunity to investigate the ageing process, chronic diseases, and the effect of common medicines in older people. Alessandro trained in medicine and geriatrics in Italy and gained knowledge on epidemiology of ageing and qualitative research methods during a 3-year fellowship at the Luigi Ferrucci laboratory at the US National Institute on Aging. He also became familiar with clinical drug development, including randomised clinical trial design and medical monitoring, when he worked for 6 years for the pharmaceutical industry. Dr Ble is currently supported by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR) and has recently received research grants from NIHR and Age UK. He joined the Melzer research group (Epidemiology and Public Health) in May 2013. Alessandro has got established collaborations with research groups in Exeter (Primary Care Research, Health Statistics), in other UK universities (Cambridge, Bristol and Sheffield), and abroad, in the US (US National Institute on Aging, NIH) and in Italy. Qualifications 2008: M.Sc. in Clinical and Pre-clinical Drug Development (Rome, Italy) 2001: Geriatrician (Padua, Italy) 1995: Medical Doctor (Ferrara, Italy)

研究领域

Older people are less likely to participate in randomised clinical trials (RCTs) and, when enrolled, tend to drop out more often. Thus, the evidence-base for the use of several drugs for major clinical indications is limited in the elderly and, along with RCTs of older people, observational studies are needed to fill this knowledge gap. Moreover, given the heterogeneity of the older population, it is likely that some groups of older patients may be more likely to receive benefit from particular dugs, or, on the other hand, be at greater risk of developing adverse drug reactions. In this context, Dr Ble is investigating whether commonly prescribed preventive treatments (e.g. statins, hypertensive drugs, proton-pump inhibitors, etc.) are effective in older people as well as in younger age groups or more likely to be beneficial (or harmful) in certain groups of older patients than in others. It is also well known that there are higher rates of death in wintertime than during the rest of the year. Low temperature decreases the defences against viruses and bacteria and increases blood pressure and clotting, hence raising the risk of pneumonia, heart attack and thrombotic stroke in vulnerable individuals, especially the oldest old. Alessandro is investigating whether exposure to certain drugs or having particular health characteristics is associated with increased risk of being vulnerable to lower temperatures. Separating out older people with different characteristics and testing research hypotheses using very large databases of electronic medical records is often challenging. We are currently using a 1.9 million older patient dataset from the Clinical Practice Research Datalink for our approved protocols (http://www.cprd.com/intro.asp). Moreover, creating unbiased research with observational data is also very challenging. Alessandro collaborates with William Henley, Professor of Medical Statistics at the University of Exeter, and his research group, to develop or refine innovative statistical methods to be used in medical research and large datasets. Other research areas of interest are: the consequences of polypharmacy (i.e. the concurrent use of multiple drugs by the same individual) and multimorbidity (i.e. the concomitant presence of multiple long-term health problems) in older people; as well as the paradoxical relationship between classical risk factors for cardiovascular disease (e.g. body mass index, cholesterol, etc.) and poor outcomes (e.g. death, cardiovascular events, etc.) found in older populations.

近期论文

查看导师新发文章（温馨提示：请注意重名现象，建议点开原文通过作者单位确认）

correa delgado, masoli, Bowman K, strain, Kuchel G, Walters K, Lafortune L, Brayne C, Melzer D, ble, et al (In Press). OUTCOMES OF TREATED HYPERTENSION AT AGES 80 YEARS AND OLDER: COHORT ANALYSIS OF 79,376 PATIENTS. Journal of the American Geriatrics Society Bowman K, Correa Delgado J, Henley W, Masoli J, Kos K, Brayne C, Thokala P, Lafortune L, Kuchel G, Ble A, et al (In Press). Obesity in Older People with and Without Conditions Associated with Weight Loss: Follow-up of 955,000 Primary Care Patients. J Gerontol a Biol Sci Med Sci Article has an altmetric score of 10 Atkins JL, Pilling LC, Ble A, Dutta A, Harries LW, Murray A, Brayne C, Robine JM, Kuchel GA, Ferrucci L, et al (2016). Longer-Lived Parents and Cardiovascular Outcomes: 8-Year Follow-Up in 186,000 U.K. Biobank Participants. J Am Coll Cardiol, 68(8), 874-875. Author URL. Article has an altmetric score of 483 Ble A, Hughes PM, Delgado J, Masoli JA, Bowman K, Zirk-Sadowski J, Mujica Mota RE, Henley WE, Melzer D (2016). Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: a Quasi-Experimental Study. J Gerontol a Biol Sci Med Sci Abstract. Author URL. Full text. Article has an altmetric score of 3 Ble A, Masoli JA, Barry HE, Winder RE, Tavakoly B, Henley WE, Kuchel GA, Valderas JM, Melzer D, Richards SH, et al (2015). Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12. BMC Geriatr, 15 Abstract. Author URL. Full text. Article has an altmetric score of 6 Bowman K, Ble A, Delgado J, Melzer D (2015). CHRONIC KIDNEY DISEASE AS a RISK FACTOR FOR CARDIOVASCULAR EVENTS OR MORTALITY. GERONTOLOGIST, 55, 25-25. Author URL. Melzer D, Tavakoly B, Winder RE, Masoli JA, Henley WE, Ble A, Richards SH (2015). Much more medicine for the oldest old: trends in UK electronic clinical records. Age Ageing, 44(1), 46-53. Abstract. Author URL. Full text. Article has an altmetric score of 22 Melzer D, Bowman K, Delgado J, Ble A (2015). THE RISK FACTOR PARADOX: BIG DATA ESTIMATES FROM 1.9 MILLION OLDER PATIENTS. GERONTOLOGIST, 55, 800-801. Author URL. Ble A, Delgado J, Bowman K, Masoli JA, Streeter A, Henley W, Melzer D (2015). USING ELECTRONIC MEDICAL RECORDS TO ESTIMATE THE EFFECTIVENESS OF STATINS IN PREVENTING CARDIOVASCULAR DISEASE AND ALL-CAUSE MORTALITY IN PEOPLE 75 AND OLDER. GERONTOLOGIST, 55, 26-26. Author URL. Delgado J, Ble A, Bowman K, Masoli JA, Streeter A, Henley W, Melzer D (2015). USING ELECTRONIC MEDICAL RECORDS TO ESTIMATE THE EFFECTIVENESS OF STATINS IN PREVENTING THE INCIDENCE\ ONSET OF DEMENTIA IN PEOPLE 75 AND OLDER. GERONTOLOGIST, 55, 26-26. Author URL. Windham BG, Fumagalli S, Ble A, Sollers JJ, Thayer JF, Najjar SS, Griswold ME, Ferrucci L (2012). The Relationship between Heart Rate Variability and Adiposity Differs for Central and Overall Adiposity. J Obes, 2012 Abstract. Author URL. Article has an altmetric score of 1 Ble A, Mosca M, Di Loreto G, Guglielmotti A, Biondi G, Bombardieri S, Remuzzi G, Ruggenenti P (2011). Antiproteinuric effect of chemokine C-C motif ligand 2 inhibition in subjects with acute proliferative lupus nephritis. Am J Nephrol, 34(4), 367-372. Abstract. Author URL. Zuliani G, Volpato S, Galvani M, Blè A, Bandinelli S, Corsi AM, Lauretani F, Maggio M, Guralnik JM, Fellin R, et al (2009). Elevated C-reactive protein levels and metabolic syndrome in the elderly: the role of central obesity data from the InChianti study. Atherosclerosis, 203(2), 626-632. Abstract. Author URL. Ruggiero C, Metter EJ, Melenovsky V, Cherubini A, Najjar SS, Ble A, Senin U, Longo DL, Ferrucci L (2008). High basal metabolic rate is a risk factor for mortality: the Baltimore Longitudinal Study of Aging. J Gerontol a Biol Sci Med Sci, 63(7), 698-706. Abstract. Author URL. Volpato S, Ble A, Metter EJ, Lauretani F, Bandinelli S, Zuliani G, Fellin R, Ferrucci L, Guralnik JM (2008). High-density lipoprotein cholesterol and objective measures of lower extremity performance in older nondisabled persons: the InChianti study. J Am Geriatr Soc, 56(4), 621-629. Abstract. Author URL. Maggio M, Lauretani F, Ceda GP, Bandinelli S, Basaria S, Paolisso G, Ble A, Egan JM, Metter EJ, Abbatecola AM, et al (2007). Association of hormonal dysregulation with metabolic syndrome in older women: data from the InCHIANTI study. Am J Physiol Endocrinol Metab, 292(1), E353-E358. Abstract. Author URL. Lauretani F, Bandinelli S, Bartali B, Cherubini A, Iorio AD, Blè A, Giacomini V, Corsi AM, Guralnik JM, Ferrucci L, et al (2007). Erratum: Omega-6 and Omega-3 fatty acids predict accelerated decline of peripheral nerve function in older persons (European Journal of Neurology (2007) 14, (801-808). European Journal of Neurology, 14(9). Zuliani G, Guerra G, Ranzini M, Rossi L, Munari MR, Zurlo A, Blè A, Volpato S, Atti AR, Fellin R, et al (2007). High interleukin-6 plasma levels are associated with functional impairment in older patients with vascular dementia. Int J Geriatr Psychiatry, 22(4), 305-311. Abstract. Author URL. Zuliani G, Volpato S, Blè A, Bandinelli S, Corsi AM, Lauretani F, Paolisso G, Fellin R, Ferrucci L (2007). High interleukin-6 plasma levels are associated with low HDL-C levels in community-dwelling older adults: the InChianti study. Atherosclerosis, 192(2), 384-390. Abstract. Author URL. Vogelzangs N, Suthers K, Ferrucci L, Simonsick EM, Ble A, Schrager M, Bandinelli S, Lauretani F, Giannelli SV, Penninx BW, et al (2007). Hypercortisolemic depression is associated with the metabolic syndrome in late-life. Psychoneuroendocrinology, 32(2), 151-159. Abstract. Author URL.