Search Results for: heart disease

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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Bladder problems: Can we be less shy about having a pee?

Prof Marcus Drake

Bladder problems affect millions of people around the world, yet they remain shrouded in silence and embarrassment. Professor Marcus Drake, Chair in Neurological Urology, explores why society continues to be shy about this topic, and highlights why more medical research is needed to improve bladder care.

People do not generally spend a lot of time thinking about their bladder. After all, each pee only takes about 20 seconds. Since we might go for a pee just six times a day, that means only a couple of minutes are given over to the bladder daily.

As well as not thinking about it much, we also seem to be reluctant to talk about it. This may be a reflection on society, since peeing is a vital function yet talking about it seems to be discouraged. Perhaps this does not matter so much for most people. But it does matter for anyone with a bladder problem. This reluctance means that people can leave it very late to get help. For many it makes the experience of getting help difficult too.

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Unravelling the mystery of smaller lungs in low- and middle-income countries

Andre Amaral

In low- and middle-income countries (LMICs), a notable number of individuals have smaller lungs for their sex, age, and height, especially in South and East Asia, as well as sub-Saharan Africa. The key question: Why does this pattern persist in these regions?

This phenomenon extends beyond physiological concerns, and as indicated by recent studies, reveals a troubling link between smaller lungs and heightened risks of suffering from heart disease and diabetes. Dr André Amaral, an epidemiologist at the National Heart and Lung Institute (NHLI), explores this phenomenon.

The BOLD study

Chronic lung diseases affect millions of people of all ages worldwide. Approximately 20 years ago, the Burden of Obstructive Lung Disease (BOLD) study was set up by Imperial College London to find out more about the prevalence and determinants of chronic obstructive pulmonary disease (COPD), which back then, was already considered a leading cause of disability and death.

The BOLD study was conducted in 41 sites across Africa, Asia, Australia, Europe, the Caribbean and North America, and recruited more than 30,000 adults aged 40 years and over. The large coverage of world regions, and ethnic groups, as well as the large number of participants, all answering the same questions and undergoing the same measurements in a standardised manner, makes the BOLD study unique. Participants in this study provided information on several characteristics of their life. This included whether they had been diagnosed with lung disease, a heart disease, or diabetes, whether they smoke or ever smoked, their weight and height, and their highest level of education. The level of their lung function was measured through a medical test called spirometry, which measures how much air a person can breathe out in one forced breath.

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Tackling syncope – a significant diagnostic challenge for many

Syncope–a transient loss of consciousness–occurs in 42% of people by the age of 70. Professor Richard Sutton, Emeritus Professor of Clinical Cardiology, discusses this common medical problem, and how he has pioneered a “true but still insufficiently small interest” in it.

I have been Emeritus Professor of Clinical Cardiology at Imperial since 2011. Prior to that, I had trained in Cardiology at St George’s Hospital, the University of North Carolina, and the National Heart Hospital in London, becoming Consultant Cardiologist at Westminster Hospital in 1976. There I focused on cardiac pacing as a subspecialty. From a clinical perspective, cardiac pacing eradicated syncope (transient loss of consciousness) in patients with conduction tissue disease of the heart. So, I sought to extend the role of pacing into related syncope conditions.

My primary interest therefore became the symptom of syncope. I began this in the late 1970s, and formed a close relationship with Worthing Hospital which carried a heavy load of older patients, many of whom presented syncope. I founded an outreach clinic at Worthing which led to the receipt of many challenging patients with syncope in whom there was no obvious cause.

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Movement Foundations: How can digital tools help people to become more physically active?

Dr David Salman from the School of Public Health discusses how digital interventions could help people return to fitness following a period of illness.

I am a GP, researcher, and work at the Imperial College Healthcare NHS Trust sport and exercise medicine clinic. Part of my work is to help people become more physically active – important because it is one of the few interventions that can improve health in many different ways. If we had a similar drug or intervention that reduced the risk of heart disease, diabetes, dementia, depression, risk of falls, and several cancers, then everyone would probably be on it. The problem is that almost one-third of people in the UK are not physically active enough for good health. This is partly because barriers to being physically active exist across individual and cultural factors, such as illness, pain or different conceptions of what physical activity or exercise mean; infrastructure aspects such as safety, facilities and lighting, through to national and global policy. Therefore, this wonder medicine is not equally available to all.

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The Future is Fungal

illustration of fungi

Jenny Shelton takes us through the incredible potential of fungi and how this diverse, yet often overlooked, species may hold many of the answers to global challenges, from climate change to food insecurity. 

Fungi play important roles in nature, food production, medicine, industry and bioremediation yet we have only discovered ~150,000 out of a potential 6.3 million fungal species. Just recently, a PhD student found undiscovered fungal species in seeds stored at the Millennium Seed Bank and estimates the whole collection might contain up to 1 million new species! You might be surprised to learn that fungi are more closely related to animals, and therefore humans, than they are to plants, and that the combined biomass of all fungi on Earth is 200 times greater than the entire human race.

The responses I often get when I tell someone I’m a mycologist is “Eurgh, I hate mushrooms!” or “Can you cure my athlete’s foot infection?”. It’s no surprise that this is their reaction given how little fungi feature in the U.K. school curriculum, or even in most biology and medical degrees, but it is such a shame given how magnificently diverse the Kingdom of Fungi is. (These responses also, unknowingly, capture the yin and yang of fungi: while this article is about the good that they can do it is important to acknowledge that fungal infections cause misery to millions of people around the world every year.)

Keeping in mind the challenges facing us – climate change, global food insecurity and infectious disease pandemics –I hope you will agree with me that the solutions to many of our problems could be fungal! (more…)

From Brazil to Westminster: learning from a community health worker model

On World Health Day, Dr Matthew Harris reflects on what we can learn from Brazil’s community health worker model.

Back in 2011, I was telling a senior consultant in Public Health about Brazil’s extraordinary primary care system which is based on an army of over 250k community health workers (CHW). It had been established in the northeast of the country in the mid-1990s, in response to a cholera epidemic, and since had scaled nationally, now serving over 70% of the population.  The principles seemed simple enough. Individuals from a neighbourhood are recruited and trained on a wide array of health and social care issues for a few weeks and then spend their working days visiting all the households that they are responsible for.  Not many households, just around 200 each, but each CHW makes sure that the households get at least one visit per month. (more…)

How we completed our BSc research projects remotely

Three medical students reflect on how they navigated and completed their intercalated BSc research projects remotely amid the pandemic.

Ioannis Panselinas, BSc Translational Respiratory Medicine

Had someone told me back at the start of 2020 what the year would have in store, I would have probably said that they had stolen ideas from an Orwellian dystopia. Yet the world is currently in the grips of one of the most terrible pandemics in living memory. And among all the global disruption were us 4th year Imperial medics having to face a transition to remote working in the middle of project period. Unsurprisingly, lab work cannot be done from the comfort of our homes. So, as COVID-19 hit the UK, we were forced to cut short our experiments and were ultimately left with a looming deadline and a project to complete.  In retrospect, I think I can sum up my experience with the 5 stages of COVID disruption:

Denial, Bargaining, Panic, Depression, Acceptance. (more…)

A smoke-free country: how will we get there?

The Government recently announced plans to create a smoke-free society by 2030 – Dr Nick Hopkinson outlines some of the steps towards achieving this ambition.

Tobacco smoking remains a huge public health issue. Although population smoking rates continue to fall – now down to 14.4% of adults – smoking is still responsible for around 100,000 deaths per year in the UK, and for around half the difference in life expectancy between rich and poor. Smoking rates are high in areas of deprivation, in people with mental health problems and among people who identify as LGBT.

The Government’s recent green paper, Advancing our health: prevention in the 2020’s, although in many areas light on detail, funding, delivery and ambition, does set out some important markers on smoking and some potentially interesting developments around funding tobacco control. (more…)

It takes guts to fight obesity: how hormones could hold the key to sustainable weight loss

To mark National Obesity Awareness Week, Professor Tricia Tan explains how new research is harnessing the power of hormones to treat obesity more effectively.

Obesity has been an issue for centuries. However, it has transformed from a disease that once only touched a small number of people to a major health concern that currently affects one in four adults in the UK. As a result, obesity is now always in the news. Although many obese people are reasonably healthy, we know that obesity increases the risks of developing heart disease, diabetes mellitus (high blood sugar), cancer, respiratory problems (such as sleep apnoea and asthma) and arthritis. Obesity and its related health problems threaten to reverse the gains in lifespan that we have seen through the 20th century. So, how can we begin to tackle it? (more…)