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Adrienne O’Neil

A/Prof O’Neil is the Director of Heart and Mind Research at IMPACT and Deputy Director of Food and Mood Centre. Her co-appointment is funded by the Heart Foundation as part of a Future Leader Fellowship and the Wilson Foundation.

She is a behavioural scientist who has been researching the link between mental and cardiovascular health for over a decade. A key part of her work is investigating the role that lifestyle plays in the onset and outcomes of depression and cardiovascular disease, both respectively, in relation to each other and when they co-occur. She works with the team at the Food and Mood Centre to apply learnings from cardiology and other areas of chronic disease prevention and management to psychiatry. Adrienne completed her doctoral training at the School of Public Health & Preventive Medicine, Monash University and international post-doctoral training at Stanford University. Upon her return to Australia, she spent 5 years at the School of Population and Global Health, University of Melbourne. She has over 100 publications and has received 10+ years of Category 1 personnel funding.  Adrienne is passionate about sport and music.

Adrienne leads the following studies:

(a) Intermittent Fasting as a Therapeutic Approach to Heart Failure: A Pilot Study (Deakin University funding; Co-Investigator)

Recent animal studies have provide important clues for a new therapeutic approach to Chronic Heart Failure; caloric restriction via intermittent fasting (IF). In rat models of CHF, 6 weeks of IF on alternate days reduced body weight and successfully reversed cardiovascular damage. Relative risk of death was reduced by 84%. 12 months of IF further reversed symptoms via pro-angiogenic, anti-apoptotic and anti-remodelling effects. A recent study of patients with a subtype of CHF (without reduced ejection fraction) showed caloric restriction was safe and feasible over 20 weeks, with positive effects on symptom severity. Taken together, IF presents as a plausible and promising therapeutic approach for CHF.We are conducting a pilot study of 10 patients to investigate whether IF has short term health benefits and is feasible for patients with CHF with reduced ejection fraction over 12 weeks.

(b) Associations between depression, anxiety & autonomic function in acute coronary syndrome patients: the ADVENT study (NHMRC funding; Co-Investigator & Project Director)

From 2012-14, we conducted a prospective cohort study in 416 heart attack patients to determine how mental health symptoms cluster in the 2 years after discharge. We were especially interested in how autonomic nervous system assessed by heart rate variability moderated long term outcomes. Adrienne is researching  the psychophysiological mechanisms underpinning the associations between somatic subtypes of depression and anxiety as predictors of 5 year readmission and mortality.

(c) The relationship between work-home stressors and cardiovascular risk: an ecological momentary assessment study of Victorian workers (University of Melbourne funding; Lead Investigator)

Resting heart rate (HR) is a good marker of overall health. The prognostic value of HR during sleep has only recently been realised. During sleep, the CV system has a chance to rest, reflected by a “dip” in HR compared with waking resting HR. The absence, or blunting, of nocturnal HR dipping has been related to CV and all-cause mortality independent of blood pressure dipping and of other confounding factors. Daytime risk factors for nocturnal non-dipping in HR are not well understood but evidence from blood pressure research has shown that job strain and other psychosocial factors can predict nocturnal blood pressure non-dipping. Given that nocturnal blunting in HR appears an early indicator of CVD incidence, this study uses ecological momentary assessment techniques to identify modifiable risk factors and protective factors that predict this phenomenon. The study is conducted over 14 days in a cohort of Victorian workers across 3 organisations.

(d) The impact of maternal adversity on the cardiovascular health of offspring: the ALSPAC longitudinal study of mothers and children (University of Melbourne funding; Lead Investigator)

The Developmental Origins of Health and Disease hypothesis proposes that chronic diseases like CVD originate here as a result of cardiovascular, metabolic and endocrine adaptations a fetus makes in response to an adverse fetal environment. Much of the work in this area has focussed on maternal nutrition during pregnancy and birth weight, but maternal social adversity may act in a similar fashion to induce disease in offspring. Prenatal psychological stress, as a component of social adversity has been linked to intrauterine growth restriction and an increased risk of premature birth; in turn elevating a child’s risk of developing heart disease in later life. This study will determine whether social adversity experienced by mother’s during pregnancy influences the long-term CV trajectory of offspring, and the epigenetic pathways by which this may occur. Data from over 14,000 pregnant women and their children enrolled in the well-established ALSPAC study, a world-leading, birth cohort study conducted in the United Kingdom, will be used to answer these questions.

Research areas and skills: common mental disorders, cardiovascular disease, lifestyle, social determinants, sex/gender, behavioural science, epidemiology