Blog posts

Know your numbers – How home monitoring is redefining hypertension care

Dr Amit KauraDr Amit Kaura, Honorary Clinical Lecturer in the National Heart and Lung Institute, discusses the future of blood pressure monitoring in this blog post for ‘Know your Numbers!’ week – a campaign encouraging people to check their blood pressure.

Hypertension, or high blood pressure, is a major global health issue, affecting over 1.3 billion people. Yet, despite its prevalence, many people don’t fully understand what hypertension is, how it impacts health, and how they can manage it effectively.

Hypertension occurs when the force of blood against the walls of your arteries is consistently too high. This force, known as blood pressure, is measured in two numbers: systolic pressure, the pressure in your arteries when your heart beats, and diastolic pressure, the pressure when your heart is resting between beats. A normal blood pressure reading is considered to be around 120/80 mmHg, while readings consistently at 140/90 mmHg or higher indicate high blood pressure.

Often called the ‘silent killer,’ hypertension typically presents no symptoms until significant damage has occurred. Left unchecked, uncontrolled hypertension can lead to serious health issues, including heart disease, stroke, and kidney failure.

My journey into hypertension research is rooted in my background in data analytics in cardiovascular sciences. Hypertension, with its inherently numerical nature, fascinated me from the start. It is not just a static measurement; it is dynamic, with fluctuations that occur throughout the day and in response to various stimuli. This complexity piqued my interest and led me to explore the deeper intricacies of how we define and diagnose hypertension.

The traditional approach of diagnosing hypertension based on a single cut-off value – usually 140/90 mmHg – seemed overly simplistic to me. Through my research, I began to question whether this binary threshold truly captures the nuanced reality of hypertension. There is a wealth of data on the fluctuations and patterns of blood pressure that could offer more insight into cardiovascular risk than a one-time measurement.

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Embracing sleep for cognitive health: Insights from our recent study

Dr Raha West presenting her findings in South Korea

Are you a morning ‘lark’ or a night ‘owl and how is this linked to brain performance? To mark Sleeptember, Dr Raha West from the Department of Surgery and Cancer explores her recent research on over 26,000 people which found those who are naturally more active in the evening scored better on intelligence, reasoning and memory tests.

As we slip towards Sleeptember, a month dedicated to raising awareness about the importance of sleep, it’s the perfect time to reflect on the findings of our recent study published in the BMJ Public Health. Our analysis delves into how sleep duration, chronotype (whether you’re a morning person or an evening person), and various health and lifestyle factors influence cognitive performance in older adults. 

The Motivation Behind Our Study 

The importance of sleep in maintaining overall health, particularly brain health, has always intrigued me. The idea that our daily sleep patterns, including how long and when we sleep, could significantly impact our cognitive abilities led me to explore this further. Previous research has shown that poor sleep quality and duration are linked to various health issues. Still, the specific influence of chronotypes on cognition, especially in older adults, remains under-explored. 

Methodology and Participant Selection 

Our study utilised data from the UK Biobank, which includes a comprehensive set of health information from over half a million participants aged 40 and above. We focused on 26,820 individuals who completed detailed sleep and cognitive assessments. Participants were divided into two cohorts based on the cognitive tests they completed, ensuring a robust data analysis. 

Key Findings: Sleep Duration and Cognitive Performance 

We discovered that sleeping 7-9 hours per night is optimal for cognitive health. Both shorter and longer sleep durations were associated with poorer cognitive performance. This finding emphasise the importance of maintaining adequate sleep duration to support brain function.   

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Celebrating Regius Professor David Holden’s profound impact on microbiology at Imperial and beyond

In this piece Professor Ramesh Wigneshweraraj pays tribute to Professor David Holden, who retired as Regius Professor of Infectious Disease this summer.  

Foreword from Professor Deborah Ashby, Dean of the Faculty of Medicine 

I am very grateful to Ramesh for penning this wonderful tribute to Professor David Holden, who retired in May having contributed so much to his field and our university. 

His Regius Professorship in infectious disease was announced on 6 June 2016, when the honour was granted by Queen Elizabeth II as part of her 90th birthday celebrations. It was Imperial’s second, and at the time was one of only 26 Regius Professorships to have been granted since the reign of Queen Victoria. It recognised the world-leading infection research at Imperial that David has been the epitome of.

I congratulate David on all that he has achieved and wish him all the very best in his retirement.

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Completing the jigsaw: can milk banks contribute to transformed perinatal health in the UK?

Dr Natalie Shenker MBE

This week marks World Breastfeeding Week, a global campaign dedicated to informing, engaging, and galvanising action on breastfeeding and related issues. Dr Natalie Shenker MBE from the Department of Surgery and Cancer reflects on the progress made in related maternal health research in 2024, and explores how milk banks can help in the much-needed transformation of perinatal healthcare in the UK.

2024 has already been a remarkable year for human milk and lactation science. As interest grows globally in the sector, our understanding of the complex and ancient evolutionary physiological strategies involved, and their impact on infant and maternal health, deepens. The maternal health impacts of lactation and how to best support families are the key focuses of my research, and like much of the work across women’s health, has been largely ignored by mainstream science.  

In partnership with The George Institute, the new Women’s Health Network at Imperial College London is seeking to correct these crucial gaps. Excitingly, our study into the mechanisms through which breastfeeding can reduce the risk of certain types of cancer has received further funding from Breast Cancer Now. Yet, there is still so much to discover. Just last month an entirely new hormonal response that explains how breastfeeding protects against osteoporosis was described by scientists at UC Davis. They found bone metabolism increases during lactation to keep up with the large amount of calcium required to produce milk, at the same time as levels of the protective hormone oestrogen fall. Scientists were therefore previously stumped as to how breastfeeding prevents rather than causes maternal osteoporosis. The work, published in Nature, found that during breastfeeding, certain neurons in the brain called KISS1 neurons release a protein called CCN3. This protein helps increase bone repair, boosts the activity of skeletal stem cell activity and even speeds up how quickly fractures repair.

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Enhancing quality of life for head and neck cancer patients

 

Grainne Brady

Did you know that each year, amost 13,000 people in the UK will be given the news that they have head and neck cancer? Unfortunately, these numbers continue to rise. To mark World Head and Neck Cancer Day, we hear from Grainne Brady, PhD Student at Imperial’s Department of Surgery and Cancer, NIHR Clinical Doctoral Research Fellow and Speech Language Therapist at the Royal Marsden NHS Foundation Trust London. She shares her expertise on the link between head and neck cancer and changes to swallowing, communication and the potential impact on quality of life. 

Treatments for HNC include surgery, radiation and chemotherapy(1). Traditional risk factors for HNC include a history of tobacco and alcohol use (2). More recently, human papilloma virus (HPV) has been recognised as a risk factor for the development of oropharyngeal cancer which is a subtype of cancer affecting the back of the throat, tonsils, back of the tongue and soft palate (2). The discovery that a virus can cause this condition has led to the development of a UK-wide HPV vaccination programme available for both boys and girls aged 12-13 years (3). 

There have been huge advances in the treatment of HNC over the past two to – three decades. These include advanced radiation techniques like intensity-modulated radiation therapy and minimally invasive surgeries such as transoral robotic surgery, which are now standard of care techniques (4).   

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Postcards from Kampala: Data and Dashboards in Uganda

Nina Zhu enjoying coffee and a chat with Dr Sanjeev Singh, CAMO-Net India lead
Nina Zhu enjoying coffee and a chat with Dr Sanjeev Singh, CAMO-Net India lead

The Centres for Antimicrobial Optimisation Network (CAMO-Net) recently convened an insightful meeting at Makerere University in Uganda. This international event brought together researchers dedicated to the critical challenge of antimicrobial resistance (AMR). Throughout the week, attendees engaged in a series of informative presentations exploring data-driven approaches to optimising antibiotic use. Hear first-hand from Dr Nina Zhu from the Department of Infectious Disease on what her experience at the event was like. 

I recently returned from Kampala, Uganda, where I spent an incredible week at Makerere University for the Centres for Antimicrobial Optimisation Network (CAMO-Net) event. Colleagues from around the world came together in Kampala to share knowledge, take part in workshops, and learn more about the work our Uganda National Hub does to address antimicrobial resistance (AMR) in Africa and beyond. 

Data and Dashboards for Optimising Antibiotic Use 

The event’s theme was ‘Data and Dashboards’. Harnessing the power of data through strategic and targeted studies to generate new knowledge related to optimising antimicrobial use is a key theme of CAMO-Net. As my work focuses on using data linkage and system dynamics modelling to understand healthcare-associated infections and AMR, it was a perfect week for me!  

I was joined in Kampala by CAMO-Net members from four other countries: Brazil, India, Malawi, and South Africa. We received such a warm welcome from our Ugandan hosts and started the week with a networking session at a local restaurant. At the reception, Dr Andrew Kambugu, CAMO-Net Uganda lead and head of Makerere’s Infectious Diseases Institute (IDI) gave a fascinating showcase of IDI’s history. It was a perfect blend of networking and getting to know more about the impressive strides IDI has made in infectious diseases, data, and AMR. 

Professor Umar Kakumba, the 1st Deputy Vice Chancellor of Makerere University, and Dr Andrew Kambugu, CAMO-Net Uganda lead, welcomed the whole CAMO-Net team

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St Mary’s Medical School: End of a chapter

Professor John Tregonning (front centre) in the early days of his career in the Department of Surgery and Cancer.

As the Faculty of Medicine prepares for the full decant of the St Mary’s Medical School Building, Professor John Tregoning, Professor in Vaccine Immunology in the Department of Infectious Disease, takes a trip down memory lane, reflecting on almost 20 years spent working in the “site steeped with history.”

On the 1st of August 2024, as part of a wider departmental move, I will leave the St Mary’s Hospital campus having worked there for nearly half my life. As such, it felt like time to reflect.

I first crossed the threshold when the St Mary’s medical school had just merged with Imperial in 1999, visiting friends who were studying there. Admittedly, it was not in an academic capacity. I went to the long-closed, but legendary bar in the basement (allegedly it closed because seeing future doctors heavily inebriated was off-putting to those visiting the hospital). I don’t remember much of that night, a fact I am putting down to time passed, rather than beers consumed.

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Spotlighting Air Quality Researchers on Clean Air Day

Group photo of Aerosol Science Team at Imperial’s Environmental Research Group in front of an air quality monitoring site (Ian is fifth from the left)
Group photo of Aerosol Science Team at Imperial’s Environmental Research Group in front of an air quality monitoring site (Dr Ian Chen is fifth from the left)

Air pollution is linked to 43,000  deaths each year in the UK.  The World Health Organization and the UK Government recognise that air pollution is the largest environmental threat to our health. To mark Clean Air Day, we’re spotlighting Dr Ian (Gang) Chen and Dr Kayla Schulte from Imperial’s Environmental Research Group who are leading the charge in the fight against air pollution. 

Dr Ian (Gang) Chen 

As a kid growing up in China, I always thought the haze was just another humid day with fog. Only after watching the Chinese-made documentary, Under the Dome in 2015, did I realise how polluted our air was. I was shocked and determined to do something about it. To begin my research journey in air pollution, I pursued a two-year MPhil program at the University of Toronto. There, I focused on developing a low-cost sensor to detect soot particles in developing countries. After that, I became interested in identifying and quantifying sources of air pollutants for my PhD studies at ETH Zurich, since it’s the most straightforward way to target emission sources and mitigate air pollution. My research has focused on this topic ever since.  

Our team (Aerosol Science) at Imperial’s Environmental Research Group maintain two air quality supersites in London, where we use the latest technology to continuously monitor pollution. One site is located near Baker Street, central London, a traffic station, while the other is an urban background site located in Honor Oak Park in south London. On Clean Air Day 2023, we launched a particulate matter (PM) dashboard which shows the hourly chemical composition of the solid particles and liquid droplets found in our air.  Making this data open-access and interactive is crucial for public understanding of the air we breathe. The organic mass in PM often contains millions of compounds and my research focuses on identifying and quantifying its sources. In the coming years, we aim to provide near real-time source information for PM on this dashboard, so that both the public and policymakers can understand where the pollution is coming from.  

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Early onset Type 2 Diabetes: A growing concern

Dr Shivani Misra

While traditionally seen as a disease of older adults, type 2 diabetes is increasingly affecting younger people. This “early onset” form carries a higher risk of complications and earlier death. To mark Diabetes Awareness Week, Dr Shivani Misra from the Department of Metabolism, Digestion and Reproduction sheds light on her research which aims to tackle early onset type 2 diabetes in individuals from minority ethnic backgrounds.

When I was at medical school, I learned that type 2 diabetes was a condition that affected middle-aged or older adults often living with obesity. However, these days the demographics of who is affected by type 2 diabetes have drastically changed. More and more younger adults and children are affected with type 2 diabetes and we call this early onset type 2 diabetes, typically defined as a diagnosis before the age of 40 years.

What we do know from large analyses across the world, is that when you’re diagnosed with type 2 diabetes at earlier age, your diabetes can progress through to complications very rapidly and also reduce life expectancy. Of even greater concern is the impact on women living with early onset of type 2 diabetes, in whom pregnancy can be complicated because of  type 2 diabetes and there’s a higher risk of foetal death, sadly.

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The importance of annual reviews for COPD care

Man at COPD review

Currently, there are considerable gaps in the care of people with chronic obstructive pulmonary disease (COPD). Parris Williams, PhD student at the National Heart and Lung Institute (NHLI), highlights why improving the access, delivery and quality of annual COPD reviews is crucial to supporting 1.4 million patients in the UK with the condition.

Chronic obstructive pulmonary disease (COPD), a chronic condition causing restricted airflow and breathing problems, is the second most common lung disease in the UK. Currently 1.4 million people in the UK have a COPD diagnosis. Recommended by the British Thoracic Society and NICE guidelines, annual COPD reviews are a key element in COPD care. These reviews are an opportunity for the patient to discuss their condition with their medical team, alongside inhaler/medication revisions and opportunities for onward referrals if needed. When delivered correctly, COPD annual reviews increase the health and reduce exacerbation risk for patients.

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