J. David Spence CM, MD, FRCPC, FAHA
Professor Emeritus of Neurology and Clinical Pharmacology, Robarts Research Institute, Western University, London, Ontario, CanadaProfessor Spence focused on prevention of stroke throughout his career. He pioneered the measurement of 2-dimensional carotid total plaque area beginning in 1986, and since 1994 has collaborated with Profs. Aaron Fenster and Grace Parraga at the Robarts Research Institute in measurement of 3D plaque volume, vessel wall volume, plaque ulceration and assessment of vulnerable plaque. His research program focuses on measurement of atherosclerosis by ultrasound, for risk stratification, genetic and biological study of atherosclerosis, and for assessing effects of new therapies. He pioneered a new approach to vascular prevention - “treating arteries instead of treating risk factors” - that has markedly reduced risk among high-risk patients with carotid stenosis. Other areas of expertise include the effect of grapefruit on drug metabolism, vitamin therapy for homocysteine, the clinical pharmacology of stroke prevention, physiologically individualized therapy for resistant hypertension, identification of high-risk asymptomatic carotid stenosis and the role of the intestinal microbiome in atherosclerosis. His publications include 4 books and more than 600 publications in peer-reviewed journals. He has presented more than 600 lectures in 42 countries. He was a member of the American Heart Association Stroke Council, and is a Fellow of the Canadian Academy of Health Sciences, , the International Stroke Society and the International Hypertension Society. In 2015 he received the Research Excellence Award from the Canadian Society for Atherosclerosis, Thrombosis and Vascular Biology. In 2019 he was appointed to the Order of Canada, “for his contributions to the understanding of atherosclerosis and Stroke Prevention”. In 2020 he received the William Feinberg Award from the American Heart Association for excellence in clinical research.
B.A. University of Western Ontario 1965
M.D. University of Western Ontario 1970
Fellowship in Clinical Pharmacology at the Cardiovascular Research Institute, University of California at San Francisco 1974-76
Recent Contributions to PracticeUpdate:
- Potential Off-Label Indication of Metformin for Ischaemic Stroke
- Glucose Level–Lowering Effects and Safety of Low vs Standard Dose of Lobeglitazone in Patients With T2D With Inadequate Control on Metformin and DPP4 Therapy
- Long-Term Low-Dose Acetylsalicylic Use Protects Against Vascular Dementia and AD in Patients With Coronary Heart Disease
- Diabetes Associated Risk for Mortality Increases With Time Among First Stroke Survivors
- Association Between Prediabetes and Risk of All-Cause Mortality and Cardiovascular Disease
- Hyperglycemia, Duration of Diabetes, and Intracranial Atherosclerotic Stenosis by Magnetic Resonance Angiography: The ARIC-NCS Study
- Stroke Risk Associated With Glycemic Control in Patients With Type 2 Diabetes
- Association of Diabetes and Glycated Hemoglobin With the Risk of Intracerebral Hemorrhage