Alok Gupta, M.D.
Associate Professor - Research
Outpatient Clinic Unit
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M.D., Osmania Medical College, Hyderabad, A.P., India., 1979
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.
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.
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.
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.
Gupta AK, Ross EA, Myers JN, Kashyap ML. Increased Reverse Cholesterol Transport in Athletes. Metabolism. 1993 Jun; 42(6):684-90.
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.
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.
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Collaborative Research Group. Diuretic versus alpha-blocker as first-step antihypertensive therapy: final results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Hypertension. 2003 Sep; 42(3):239-46. Epub 2003 Aug 18.
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.
Wright JT Jr, Harris-Haywood S, Pressel S, Barzilay J, Baimbridge C, Bareis CJ, Basile JN, Black HR, Dart R, Gupta AK, Hamilton BP, Einhorn PT, Haywood LJ, Jafri SZ, Louis GT, Whelton PK, Scott CL, Simmons DL, Stanford C, Davis BR. Clinical Outcomes by Race in Hypertensive Patients With and Without the Metabolic Syndrome. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Arch Intern Med. 2008; 168(2):207-217.
Gupta AK, Greenway FL, Cornelissen G, Pan W, Halberg F. Prediabetes is associated with abnormal circadian blood pressure variability. J Hum Hypertens. Received 6 March 2008; Accepted 16 March 2008; Published online 15 May 2008. 2008 Sep; 22(9):627-33.
Rogers PM, Mashtalir N, Rathod MA, Dubuisson O, Wang Z, Dasuri K, Babin S, Gupta A, Markward N, Cefalu WT, Dhurandhar NV. Metabolically Favorable Remodeling of Human Adipose Tissue by Human Adenovirus Ad-36. Diabetes. 2008 Sep;57(9):2321-31. Epub 2008 Jul 3.
Vander Wal JS, Gupta A, Khosla P, Dhurandhar NV. Egg Breakfast Enhances Weight Loss. Int J Obes (Lond). 2008 Oct; 32(10):1545-51. Epub 2008 Aug 5.
Greenway FL, Whitehouse MJ, Guttadauria M, Anderson JW, Atkinson RL, Fujioka K, Gadde KM, 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.
Bray GA, Bouchard C, Church TS, Cefalu WT, Greenway FL, Gupta AK, Kaplan LM, Ravussin E, Smith SR, Ryan DH. It Is Time to Change the Way We Report and Discuss Weight Loss? Obesity (Silver Spring). 2009 Apr; 17(4):619-21.
Gupta AK, Smith SR, Greenway FL, Bray GA. Pioglitazone treatment in type 2 diabetes mellitus when combined with portion control diet modifies the metabolic syndrome. Diabetes Obes Metab. 2009 Apr; 11(4):330-7.
Gupta AK, Bray GA, Greenway FL, Martin CK, Johnson WD, Smith SR. Pioglitazone, but not metformin, reduces liver fat in Type-2 diabetes mellitus independent of weight changes. J Diabetes Complications. 2010 Sep-Oct; 24(5):289-96. Epub 2009 Jul 4.
Greenway FL, Dunayevich E, Tollefson G, Erickson J, Guttadauria M, Fujioka K, Cowley MA; for the NB-201 Study Group. Comparison of Combined Bupropion and Naltrexone Therapy for Obesity with Monotherapy and Placebo. J Clin Endocrinol Metab. 2009 Dec; 94(12):4898-906. Epub 2009 Oct 21.
Ryan DH, Johnson WD, Myers VH, Prather TL, McGlone MM, Rood J, Brantley PJ, Bray GA, Gupta AK, Broussard AP, Barootes BG, Elkins BL, Gaudin DE, Savory RL, Brock RD, Datz G, Pothakamuri SR, McKnight GT, Stenlof K, Sjöström LV. Nonsurgical weight loss for extreme obesity in primary care settings: results of the Louisiana Obese Subjects Study. Arch Intern Med. 2010 Jan 25; 170(2):146-54.
Martin CK, Gupta AK, Smith SR, Greenway FL, Han H, Bray GA. Effect of pioglitazone on energy intake and ghrelin in diabetic patients. Diabetes Care. 2010 Apr; 33(4):742-4. Epub 2010 Jan 12.
Gupta AK, Johnson WD. Prediabetes and Prehypertension in Disease Free Obese correlates with an Exacerbated Proinflammatory Milieu. J Inflamm (Lond). 2010 Jul 26; 7:36. Highly accessed.
Gupta AK, McGlone M, Greenway FL, Johnson WD. Prehypertension in disease-free adults: a marker for an adverse cardiometabolic risk profile. Hypertens Res. 2010 Sep; 33(9):905-10. Epub 2010 Jun 10. Featured on the cover of October 2010 issue.
Gupta AK, Cornelissen G, Greenway FL, Dhoopati V, Halberg F, Johnson WD. Abnormalities in circadian blood pressure variability and endothelial function: pragmatic markers for adverse cardiometabolic profiles in asymptomatic obese adults. Cardiovasc Diabetol. 2010 Sep 24; 9(1):58. Highly accessed.
Rochon J, Bales CW, Ravussin E, Redman LM, Holloszy JO, Racette SB, Roberts SB, Das SK, Romashkan S, Galan KM, Hadley EC, Kraus WE; CALERIE Study Group. Design and conduct of the CALERIE study: comprehensive assessment of the long-term effects of reducing intake of energy. J Gerontol A Biol Sci Med Sci. 2011 Jan; 66(1):97-108. Epub 2010 Oct 5.
Gupta AK, Brashear MM, Johnson WD. Coexisting prehypertension and prediabetes in healthy adults: a pathway for accelerated cardiovascular events. Hypertension Research, (2011) 34, 456–461; doi:10.1038/hr.2010.267; published online 13 January 2011.
Krishnapuram R, Dhurandhar EJ, Dubuisson O, Kirk-Ballard H, Bajpeyi S, Butte NF, Sothern MS, Larsen-Meyer E, Chalew S, Bennett B, Gupta AK, Greenway FL, Johnson WD, Brashear M, Reinhart G, Rankinen T, Bouchard C, Cefalu WT, Ye J, Javier R, Zuberi A, Dhurandhar NV. A Template to Improve Glycemic Control without Reducing Adiposity or Dietary Fat. Am J Physiol Endocrinol Metab. 2011 Jan 25. [Epub ahead of print].
Gupta AK, Brashear MM, Johnson WD. Prediabetes and Prehypertension in Healthy Adults Are Associated With Low Vitamin D Levels. Diabetes Care. 2011 Jan 31. [Epub ahead of print].
Singh RB, Fedacko J, Pella D, Macejova Z, Ghosh S, de Amit K, Begom R, Tumbis ZA, Haque M, Vajpeyee SK, de Meester F, Sergey C, Agarwalo R, Muthusamy VV; Five City Study Group, Gupta AK. Prevalence and risk factors for prehypertension and hypertension in five Indian cities. Acta Cardiol 2011 February; 66(1): 29-37.
Bajpeyi S, Pasarica M, Moro C, Conley K, Jubrias S, Sereda O, Burk DH, Zhang Z, Gupta A, Kjems L, Smith SR. Skeletal muscle mitochondrial capacity and insulin resistance in type 2 diabetes. J Clin Endocrinol Metab. 2011.
Hendricks EJ, Greenway FL, Westman EC, Gupta AK. Blood Pressure and Heart Rate Eff