Western University, Canada - London Ontario

| Monday December 22, 2014
9:51 AM

Neurology - Area of Focus

Academic Appointment

Professor of Neurology and Clinical Pharmacology

Bio Sketch

Dr. Spence has devoted his entire career to stroke prevention. During his first two years of training in Neurology at Western with Dr. Henry Barnett, he saw over 1000 strokes, half of which were due to hypertension. This led him to complete training in Internal Medicine at Western, and then Clinical Pharmacology at the University of California at San Francisco. He returned to London to establish at Victoria Hospital the second hypertension clinic in Canada. With major efforts by the Department of Family Medicine and the hypertension clinic, stroke in London was reduced by half within 5 years. In 1995 he moved to University Hospital to join the stroke team and establish clinics aimed at stroke prevention and premature atherosclerosis.

Research

Dr. Spence pioneered the measurement of 2-dimensional carotid plaque area for three main purposes: management of patients, genetic research and evaluation of new therapies. He developed a new paradigm for vascular prevention: treating arteries, based on carotid plaque measurements, rather than merely treating risk factors such as LDL cholesterol to target levels. Using that approach, he and colleagues recently showed that most patients with asymptomatic carotid stenosis are better off with intensive medical therapy, and that transcranial Doppler detection of microemboli can identify those (less than 5% of patients) who might benefit from endarterectomy or stenting. In these high-risk patients, the two-year risk of stroke, and the two-year risk of myocardial infarction were both reduced from 8% to 1%.

J. David Spence

Medical Interests

  • Atherosclerosis (Thickening of artery walls)
  • Cholesterol
  • Homocysteine (An amino acid)
  • Hyperlipidemia (Abnormal blood lipid levels)
  • Hypertension (Elevated blood pressure)
  • Stroke Prevention

Office Contact Information

  • Phone:519 - 663 - 3113
  • Fax:519 - 663 - 3018
  • Address:

Siebens-Drake Building
Robarts Research Institute
1400 Western Rd
London Ontario Canada
N6G 2V2