MA BMBCh MSc MRCP(Neurol) DPhil FESO
Wellcome Trust CRCD Fellow / Consultant Neurologist
- Wellcome Trust CRCD Fellow
- Honorary Consultant Neurologist
- Acute Stroke Physician
- Fellow of the European Stroke Organisation
Understanding and modifying the relationship between cerebrovascular physiology and the risk of stroke
Dr Alastair Webb has worked at the Centre for Prevention of Stroke and Dementia since 2010, initially on an MRC Clinical Research Fellowship, completing an MSc and a DPhil, before working as an Associate Clinical Fellow with the CPSD whilst completing his clinical training as a Consultant Neurologist. Since August 2017 he has been a Wellcome Trust Clinical Research Career Develop Fellow and Neurology Consultant at the CPSD and the Department of Neurology at the John Radcliffe Hospital.
Dr Webb's research is focussed on the physiological relationship between blood pressure, cerebrovascular physiology and stroke risk. His early work used meta-analyses of published results of randomised controlled clinical trials to demonstrate that different antihypertensive medications have parallel effects on blood pressure variability and stroke risk. He subsequently established the physiological cohort study within the CPSD flagship cohort (OXVASC) to identify novel physiological indices that predict the future risk of stroke, chronic cerebrovascular injury and cognitive impairment. This ongoing study has identified and refined our understanding of indices such as arterial stiffness, blood pressure variability and cerebral arterial pulsatility as potential treatment targets.
His current work continues to use multi-modal methods of assessing the role of cardiovascular and cerebrovascular physiology (systemic human physiology, transcranial ultrasound, MRI imaging) to identify novel cardiovascular and cerebrovascular indices that predict cerebrovascular injury and cognitive decline, both in >1000 patients in the ongoing physiological study within OXVASC and more recently in ~500,000 patients in the UK Biobank study. He is the PI for the TREAT@SVDs trial of the effects of antihypertensive medications on cerebrovascular reactivity (for Oxford), the OxBP sub-study of antihypertensive treatment on cerebrovascular autoregulation and is the CI of the OxHARP study of the effects of phosphodiesterase inhibitors on cerebrovascular physiology in patients with cerebral small vessel disease, that is due to start in 2019, leading to a programme of larger phase 3 clinical trials focussed on novel cerebrovascular treatment targets.
EXPRESS: Consistency of associations of systolic and diastolic blood pressure with white matter hyperintensities: a meta-analysis.
Wilkinson I. and Webb A., (2021), Int J Stroke
Blood pressure determinants of cerebral white matter hyperintensities and microstructural injury: UK Biobank cohort study.
WARTOLOWSKA K. and WEBB A., (2021), Hypertension
Body Mass Index and Arterial Stiffness Are Associated With Greater Beat-to-Beat Blood Pressure Variability After Transient Ischemic Attack or Minor Stroke.
Webb AJS. et al, (2021), Stroke
BMI and arterial stiffness are associated with greater beat-to-beat blood pressure variability after TIA or minor stroke
WEBB A. et al, (2021), Stroke
Design of a randomised, double-blind, crossover, placebo-controlled trial of effects of sildenafil on cerebrovascular function in small vessel disease: Oxford haemodynamic adaptation to reduce pulsatility trial (OxHARP)
Webb A. et al, (2021), European Stroke Journal