Search Results for: heart disease

A deep dive into 30 years of progress and challenges

Professor Jonathan Valabhji

Diabetes now affects over half a billion people globally, including 3.8 million people in England. Type 2 diabetes, which accounts for 90-95% of all cases, has obesity as its primary modifiable risk factor. Expanding waistlines, both nationally and globally, have driven a steady increase in type 2 diabetes rates in recent decades. To mark World Diabetes Day, Professor Jonathan Valabhji OBE, from the Department of Metabolism, Digestion and Reproduction, reflects on his 30 years of experience in the field, in clinical practice, in national leadership, and in clinical and epidemiological research.  

My background in Diabetes research and clinical practice 

I qualified as a doctor in 1990 from St Bartholomew’s Hospital Medical College, London. I undertook specialist training in diabetes, endocrinology, and general medicine in North-West London, and landed at Imperial College in 1997 to undertake my MD (Doctor of Medicine degree) as a British Heart Foundation Junior Research Fellow. In those early years, I was interested in cardiovascular disease in diabetes, which at that point was responsible for the majority of deaths in people with diabetes. My work centred on understanding the paradox in type 1 diabetes: although patients often displayed healthy cholesterol profiles, they were at elevated risk of heart attacks and strokes. I spent 3 years in a lipid laboratory, using ultracentrifugation (a technique used to separate and isolate particles based on their density) to isolate high-density lipoprotein (HDL) cholesterol particles from blood samples, to try to disentangle the paradox.  

Population-level progress in cardiovascular health  

While I like to think that some of that early research advanced the field a little, it was other epidemiological and societal factors that saw cardiovascular disease fall in people with diabetes over the next two decades. Public health initiatives, such as reduced smoking rates, and improved management of blood glucose, blood pressure, and cholesterol, have collectively driven a marked decrease in cardiovascular complications, resulting in longer lifespans for people with diabetes. However, with this success came new challenges, as other and multiple long-term conditions (MLTCs) have increasingly become leading causes of illness and death. This has complicated care for patients, healthcare professionals, and the NHS.  At the same time, obesity has driven younger onset of type 2 diabetes, contributing to accelerated development of MLTCs at younger ages. 

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The complex relationship between viruses and our immune system

Prof John TregoningVirus Appreciation Day, celebrated annually on 3 October, serves a dual purpose: to foster respect and understanding for viruses while raising awareness about their serious impacts on health. To mark the day, Professor John Tregoning from Imperial’s Department of Infectious Disease shares valuable insights into influenza viruses, highlighting their effects, the importance of vaccination, and ongoing research for universal vaccines against evolving strains in our latest blog.

Viruses have an enormous impact on human health, but they don’t only infect humans. Many viruses also infect animals, plants and even bacteria. Some viruses are quite promiscuous, infecting a wide range of animal species before passing on to humans through a process known as zoonotic transmission. One of the most problematic of these zoonotic infections is influenza virus.  

The main natural reservoir of influenza virus is wild birds, particularly ducks and geese. The virus can then transmit from these birds into domestic poultry, like chickens, and to livestock, such as pigs, before ultimately reaching people. In the past five years, a new strain of avian influenza has emerged with an ability to infect an even wider range of mammalian species. It has been detected in cattle in the US.  

Influenza, the disease caused by the virus, poses a substantial health burden. It resulted in nearly 15,000 deaths in the UK in the 2022-23 winter season. As well as death, it is a significant cause of hospitalisation and general illness – with a long tail of recovery. Additionally, influenza infection doubles the risk of heart attacks and strokes for up to a year after illness. Given these risks, getting an influenza vaccine this time of year is highly recommended. As I discovered researching my latest book Live Forever one of the simplest ways of extending your life is through vaccination. A vaccine will give you protection against the most severe forms of disease caused by the virus and protect you against subsequent illness.Vaccines train your body to recognise pathogens and fight them off. To do this, they make use of a facet of immunity called immune memory. When re-exposed to the same virus, your immune response activates faster and stronger, stopping the infection in its tracks. Several aspects of immune memory can prevent subsequent infections, but an important one are antibodies – this is a type of protein that is highly specific in what it can recognise and bind. When you are immunised with influenza vaccine, you make influenza virus specific antibodies that can stop the virus from infecting you. 

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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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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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World No Tobacco Day – how to get where we need to be?

Nick HopkinsonThe path to a smokefree generation demands decisive action and innovative strategies. To mark World No Tobacco Day, Professor Nick Hopkinson from the National Heart & Lung Institute (NHLI) offers his insights, drawing on years of dedicated research to suggest ways in which we can achieve this. 

Smoking is the leading preventable cause of premature disability and death; two out of three people who continue to smoke will die from a smoking-related disease. Ending this requires two things: First, ensuring that people don’t start to smoke in the first place; and second, supporting the more than six million people in the UK who still smoke to quit.

‘Stopping the start’ involves making smoking less appealing,less affordable, and less available to children and young people. A key step to creating a smokefree generation will be steadily raising the age of sale, ensuring that tobacco products can never legally be sold to people born on or after 1 January 2009. The General Election has paused the progress of this legislation, but the policy has enjoyed cross-party support, so is almost certain to become law. We can be confident that it will be effective – youth smoking rates fell when the age of sale in the UK was increased from 16 to 18 in 2007, and similarly where it has been increased to 21 in the US. The year-on-year increase will also prevent the tobacco industry from addicting people later in life.

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From Britpop to breakthroughs: Reflecting on 30 years of HIV testing and treatment

Born on what would eventually be recognized as World AIDS Day in the 1970s, Dr Mike Emerson, now affiliated with the National Heart and Lung Institute, relocated to vibrant London during the early 1990s amidst the fervour of the Britpop era. In the backdrop of Blur and Pulp melodies, 1990s London faced the AIDS crisis. Three decades later, he is at the helm of a team investigating cardiovascular ailments in people with HIV. In this piece, Dr Emerson reflects on the advancements in HIV diagnosis and therapy, and reiterates the ongoing importance of  National HIV Testing Week. 

I was born on what was to become World AIDS day way back in the 1970s, and moved to the big smoke in the early 90s. London was exploding with Britpop excitement, and in the absence of mobile tech, we went out every night to the sounds of Blur and Pulp. 90s London was also the epicentre of the UK’s bit of the global AIDS crisis. People in their early 20s, as I was, were dying (of ignorance the government told us). I quickly learnt not to hold birthday celebrations in Soho; celebrating and mourning young friends and sons don’t mix well. Exactly 30 years later, I lead a team investigating cardiovascular disease as people live with HIV for decades and succumb to the diseases of old age. This week is HIV testing week, so it’s a good time to reflect on how far we have come and remind ourselves of the importance of HIV testing. 

Back in 1981, a couple of obscure articles noted incidences of fatal pneumonia and rare skin cancers in otherwise healthy young American men. Oddly, these men were all gay. Within months, there was an explosion of terrifying fatal illness amongst the gay communities of New York, San Francisco and, not far behind, London. People became infected with HIV following blood transfusions, and babies were born with the condition and died. When HIV tests became available, the prospect of one was terrifying, involving a week-long wait for results and a recommendation to take a friend when results were due to be delivered. 

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The Fleming Centre: Driving the fight against antimicrobial resistance.

Prof Ara Darzi, Chair, The Fleming Centre Initiative 

In the relentless pursuit of global health, few adversaries loom as large as antimicrobial resistance (AMR). AMR poses a pervasive threat to both different disease areas and public health as a whole. It has the potential to undermine modern medicine, as previously treatable common infections and injuries may once again become life-threatening. As the gravity of this crisis intensifies, The Fleming Centre will stand at the forefront of a burgeoning global movement to combat AMR. On World Antimicrobial Awareness Week,  Professor Ara Darzi, Chair of The Fleming Centre Initiative, writes about the pivotal role this centre will play in the fight against AMR and the far-reaching impact it promises to deliver.  

AMR poses a significant threat to global health, making it one of the most pressing challenges of our time. Drug-resistant infections occur when the bacteria responsible for the adaption and evolution of infections, gain the capacity to withstand drugs intended to kill them. The overuse and misuse of antimicrobial drugs, such as antibiotics and antifungals, in both humans and animals is only accelerating this process. As a result, AMR has been linked to more than one million deaths worldwide each year; a sign common infections are becoming increasingly difficult to treat as the medicines we all rely on become less effective. With people across the globe already dying from drug-resistant infections, the threat of more drugs losing their potency, will put more lives at risk.  

Deaths attributed to AMR every year
Source: Wellcome Trust (https://wellcome.org/sites/default/files/wellcome-global-response-amr-report.pdf)

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Navigating the debate on prostate cancer screening in the UK: Balancing risks, resources, and outcomes

In the rapidly evolving landscape of healthcare, few topics have garnered as much attention and controversy as prostate cancer screening in the UK. With approximately one in six men destined to face this diagnosis in their lifetime, the urgency to address this issue is undeniable. To provide clarity amidst this complexity, Rebecca Wright, Honorary GP Teaching Fellow at the School of Public Health, and Azeem Majeed, Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, at Imperial College London, delve into the heart of this debate, seeking to balance the critical factors of risks, resources, and outcomes in prostate cancer screening in England. 

Prostate cancer screening in England has become very topical and attracted considerable recent news coverage. Around one in six men will get prostate cancer at some point in their lives with incidence increasing with age. Another major risk factor is ethnicity; black men are at highest risk of prostate cancer and Asian men are at lowest risk. Other risk factors include family history, obesity and genetics; for example, those with a fault in their BRCA 2 gene (genes that produce proteins that help repair damaged DNA) have a two times higher risk of developing prostate cancer. (1) 

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Margaret Turner Warwick Centre: Can we take your breath away?

The Great Exhibition Road Festival is a free annual celebration of science and the arts each summer in South Kensington. The event showcases a diverse range of activities for people of all ages.  One of those activities, led by researchers from the Margaret Turner Warwick Centre and volunteers from the charity Action for Pulmonary Fibrosis, included an interactive activity that gave the public the opportunity to walk in the shoes of someone living with pulmonary fibrosis. Find out first-hand from Elisabeth Pyman, what happened on the day and hear from pulomary fibrosis patient, Andy, what it’s like to live with the condition.

The June weekend of the Great Exhibition Road Festival was one of quintessential British summertime weather. This celebration of science was hosted by Imperial College London in collaboration with the local community and provided a wide range of topics for people of all ages to explore. Under intermittent spells of rain, crowds of a multitudinous diversity explored the “awe and wonder” of science, the theme of this year’s festival. To welcome the public, artists and scientists populated the streets and buildings surrounding Imperial’s South Kensington campus like a sudden desert bloom.

Meanwhile, another transformation was taking place in a stand tucked away at the end of the road in the Creative Science zone. Researchers from the Margaret Turner Warwick Centre and volunteers from the charity Action for Pulmonary Fibrosis were on a mission to spread awareness about a rare lung condition known as pulmonary fibrosis. This condition is associated with a build-up of scar tissue that leads to a steady decline in lung function, with many patients becoming terminal only five years after diagnosis. Currently, there are 32,500 UK residents living with a diagnosis, but the actual number of people affected is estimated at around 100,000.

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Professor Sir Peter Barnes knighted for excellence: Reflections on his career in respiratory science

Professor Sir Peter Barnes FRS FMedSci, from the National Heart and Lung Institute (NHLI), was made a Knight Bachelor in this year’s King’s Birthday Honours “for services to respiratory science.” Sir Peter is Professor of Thoracic Medicine at the NHLI and he was Head of Respiratory Medicine at Imperial until 2017. Here he writes about his reaction to his award and describes some of the current research projects in chronic obstructive pulmonary disease (COPD).

A surprise! 

My wife opened the letter “On His Majesty’s Service” as she thought it was a tax demand – I was absolutely shocked to see I had been offered a knighthood. Of course, I was and am delighted with the award. It is very good for respiratory science and medicine, which generally receives little public attention. This is surprising as chronic lung diseases are amongst the most common in the UK, affecting one in seven people and the third ranked cause of death. I would like to dedicate this award to all the brilliant students, post-docs, research fellows, visiting scientists and colleagues that I have worked with at Imperial College London over many decades.  

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