Dr Ashraf Al-Asaly

Research Fellow

The University of Queensland Diamantina Institute
Faculty of Medicine
a.ahmed@uq.edu.au
+61 7 344 38023

Overview

Dr Ashraf Al-Asaly is an academic researcher at the Endocrine Hypertension Research Centre (EHRC), School of Medicine. He took up this position in 2012 after completing his PhD within the Centre at the University of Queensland. He obtained both his undergraduate (MBChB) and Masters degrees from Mosul University where he was appointed as a faculty member at Mosul School of Medicine in 2001 after receiving broad training in all aspects of clinical medicine after graduation in 1999. After completing a Masters degree, he continued his research activities and teaching undergraduate medical students, as well as practicing medicine, and was promoted to Lecturer status in Dec 2007 when he was awarded a scholarship to undertake PhD studies at the University of Queensland which he completed successfully in Jun 2011. His PhD yielded 5 papers with Dr Al-Asaly as first author in the high-ranking Journal of Clinical Endocrinology and Metabolism in addition to another two papers as a co-author.

His research activities are currently focused on hypertension in collaboration along with the Co-Directors of the EHRC, Prof. Michael Stowasser and Prof. Richard Gordon. Current research activities involved: improving the diagnosis of primary aldosteronism (PA), genetic aspects of PA and the detailed pathophysiology and genetic basis of Gordon's syndrome.

Awards

1) 2015- Young investigator Poster Finalist, Annual Scientific Meeting of High Blood Pressure Research Council of Australia

2) 2015- Nominated for the Alberto Ferrari prize, 25th European Meeting on Hypertension and Cardiovascular Protection, Milan

3) 2014-Travel Grant to the Annual Scientific Meeting of High Blood Pressure Research Council of Australia

4) 2012- Prize for Excellence in Hypertension Research,Queensland Hypertension Association, Australia

5) 2012- Young Investigator Travel Award for participation at the International Society Hypertension

6) 2010- Travel Grant to the Annual Scientific Meeting of High Blood Pressure Research Council of Australia.

7) 2010 -PhD student poster finalist in the Annual Scientific Meeting of High Blood Pressure Research Council of Australia

8) 2010- A Heat co-winner in the University of Queensland School of Medicine 3-Minute Thesis Competition

9) 2009 - PhD student oral finalist in the Annual Scientific Meeting of High Blood Pressure Research Council of Australia

10) 2007- A scholarship to undertake PhD studies at the University of Queensland

Research Interests

  • Hypertension
    His main research interests are in clinical hypertension. During his PhD, he studied the effects of phases of menstrual cycle, contraceptives, antidepressants, antihypertensive and renin assay method on aldosterone/renin ratio, a test used in practice to screen for primary aldosteronism (PA), the commonest specifically treatable and potentially curable form of human hypertension. He is currently examining the effects of gender and phases of menstrual cycle on diagnosis and sub-typing of PA (by fludrocortisone suppression testing and adrenal venous sampling respectively). He is also investigating the effects of menopause and hormonal replacement therapy on detection of PA. As well, he is comparing the efficacy of saline suppression testing (recumbent vs upright) vs fludrocortisone suppression testing in diagnosing PA.

Research Impacts

Hypertension (HT) affects ~30% of Australian adults, and is a leading risk factor for stroke, heart and kidney disease. Treatment usually means lifelong medications, potentially costly and poorly tolerated. However, when the cause can be identified, and reversed or specifically treated, the outcomes are often dramatic with patients being able to come off many or all antihypertensives and enjoying markedly improved quality of life. Primary aldosteronism (PA) is the most common specifically treatable and potentially curable form of HT. Aldosterone (salt-retaining hormone) excess in unrecognised PA is associated with significant cardiovascular morbidity which exceeds that due to HT alone, so that hypertensives should be screened for PA.

His PhD findings have impacted on clinical practice and improved the ability of detecting PA among hypertensive patients. He was able to show: [1] Avoiding the luteal phase during screening premenopausal women for PA by measuring aldosterone/renin ratio (ARR) should minimize the risk of false positive results. [2] Using plasma renin activity (PRA) rather than direct renin concentration (DRC) to calculate the ratio in premenopausal women is associated with less risk of false positives regardless of the time of sampling. [3] New reference ranges for ARR are required which take into account gender and sex hormone levels. [4] Certain contraceptives including Yaz (ethinyl estradiol plus drospirenone) may cause false positive ARR results and others like Implanon (sub dermal etonogestrel, third generation progestin) may have no effects on the results. [5] Selective serotonin reuptake inhibitor antidepressants can significantly reduce ARR and therefore potentially increase the risk of false negative results when screening for PA. [6] Specific treatment of PA after detection not only benefits identified patients in terms of improved blood pressure control and reduce risk of complications but also has a positive effect on quality of life.

As part of his post-doctoral work, supervised by Professor Michael Stowasser and Professor Richard Gordon, he is evaluating a new test to diagnose PA involving seated saline suppression test (SSST) instead of the much more complicated and time-consuming fludrocortisone suppression test (FST). FST needs a 5 day hospital stay to be completed while the new SSST takes just 4 hours and can be performed in an outpatient setting without apparent loss of sensitivity or specificity. The SSST has the potential to lead to substantial cost savings and many more patients with PA diagnosed and enjoying the benefits of optimal specific and potentially curative treatment.

Qualifications

  • Doctor of Philosophy, The University of Queensland
  • Master of Pharmacology, University of Mosul
  • Bachelor of Medicine and Bachelor of Surgery, University of Mosul

Publications

View all Publications

Publications

Book Chapter

  • Stowasser, Michael and Ahmed, Ashraf (2014). Quality-of-life aspects of primary aldosteronism. In Per Hellman (Ed.), Primary Aldosteronism: Molecular Genetics, Endocrinology and Translational Medicine. (pp. 197-207) New York, NY, USA: Springer. doi:10.1007/978-1-4939-0509-6_13

Journal Article

Conference Publication