Tag: Cardiovascular

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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HIV antiretroviral therapy: Getting to the heart of the matter

The HIV landscape has completely transformed since the start of the pandemic. A HIV diagnosis in the 1980s was considered fatal, as people usually progressed to AIDS due to the lack of available treatments. 42 years later, we have an array of different drug options and as a result, people diagnosed with HIV today can now expect to have near-normal life expectancies. Here, Dr Akif Khawaja from the National Heart & Lung Institute (NHLI), highlights the impact of HIV treatment over the last 42 years and how it influences cardiovascular research today.

HIV Treatment: from AZT to U=U

At the start of the pandemic, there were no available treatments. Patients would progress to AIDS and were only offered palliative care. It wasn’t until 1987 that the first antiretroviral drug, zidovudine (AZT), was licenced for the treatment of HIV. A major challenge with HIV treatment soon became apparent, as the virus can rapidly mutate and change its genetic code to become resistant to the drug supressing its replication. This challenge was quickly seen by clinicians as their patients would start to rebound from antiretroviral monotherapy (one drug regimens) as HIV became drug resistant and was able to replicate again. The introduction of combination antiretroviral therapy in 1996 has been monumental to HIV management. A change in treatment guidelines meant that patients who would have previously been given one drug, were now given three drug combinations, each targeting different parts of the HIV life cycle. This approach meant that patients could suppress HIV replication and achieve a sustained undetectable viral load, meaning that the level of virus in their blood is so low, it can no longer be detected by diagnostic tests.

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Under pressure: how raising awareness of a silent killer can save lives on a global scale

blood pressure screening

Professor Neil Poulter puts blood pressure screening in the spotlight – an effective way of reducing the burden of high blood pressure in the UK and globally.

Blood pressure screening can save lives, which may come as a surprise considering it is such a simple measurement. Blood Pressure UK was set up as a charity aimed at lowering the nation’s blood pressure (UK), with the purpose of preventing or at least reducing disability and death associated with raised blood pressure (BP).  Among their activities, they have been running a ‘Know Your Numbers’ week every year since 2007, and their thirteenth consecutive campaign week is currently underway. ‘Pressure stations’ have been set up around the UK providing free BP screening, encouraging adults across the country to know their blood pressure numbers. (more…)

Bringing patients together to tackle heart disease – the Heart Hive

Many researchers study a particular disease because they have a personal connection to someone who has been affected. For researcher Dr Nicky Whiffin, it happened in reverse.

I had been researching cardiomyopathies (diseases that affect the heart muscle) for a couple of years when my mum suddenly became very ill. Even walking up the stairs was a struggle, she had to pause halfway to catch her breath. Having just been through a very tough patch at work, it was put down to stress. I remember clearly what should have been an amazing trip to Paris in March 2016 to see England’s rugby team win the six nations grand slam – instead the trip was dominated by us all worrying about my mum’s illness. (more…)

A teaspoon of salt away from high blood pressure

This Salt Awareness Week, Dr Queenie Chan puts the salt intake guidelines to the test and looks at the reality of curbing salt intake for better heart health. 

Salt and sodium are often used interchangeably, but they’re not exactly the same thing. Sodium is a mineral that occurs naturally in foods or is added during manufacturing or both. Table salt is a combination of sodium and chloride, which was one of the most valuable modes of currency in ancient times. It has been used to preserve food for thousands of years and it is most commonly associated as a form of food seasoning. Salt also plays a role in food processing, providing texture and enhancing colour. (more…)

Building a heart, one cell at a time

Dr Michela Noseda took cardiac cells to the stage at her recent TEDx talk on how scientific approaches she uses can help us understand how to beat one of the biggest killers of our time – heart attacks.

Heart attack (myocardial infarction) remains the foremost killer worldwide. The prevalence remains high despite the fact that we have been reducing risk factors; stopping smoking, eating a healthy diet and exercising. In fact, the persistence of myocardial infarction as the most frequent cause of death is related to an ageing population and the move of people towards big cities. (more…)

Injury time: shoot-outs and sudden death

World cup

Ahead of the 2018 FIFA World Cup kick off, Dr Peter Wright explores how the stress and excitement of watching football isn’t all fun and games for our cardiovascular health.

Since time immemorial, sport has functioned as a useful substitute for direct physical conflict between, tribes, towns and nations. This year all eyes turn towards Russia, where the 21st edition of the FIFA World Cup will take place. The Russian word ‘mira’ may translate as both ‘world’ and ‘peace’, but as the pre-eminent competition of humanity’s favourite sport, ‘Чемпионат мира по футболу 2018’ is likely to be anything but relaxing for the players, officials and millions of spectators worldwide. (more…)

Survival of the fitness: from Ancient Greece to modern day preventive medicine

With London’s biggest running event of the year upon us, sport-expert Tim Grove gives a low down on the benefits of running for a healthy heart. 

Is physical activity good for us?

London Marathon – the biggest sporting spectacle of the year – is fast approaching. This Sunday will see over 40,000 runners take part in the gruelling 26.2-mile course starting at Blackheath and finishing in front of Buckingham Palace. The event is highly televised with elite runners, celebrities, politicians and fundraisers all taking part together. The London Marathon has gained popularity since its inception in 1981 and has raised over £450 million for charity, making it the world’s largest annual fundraising event. With its high media profile, the London Marathon certainly sparks the enthusiasm of the general public with many taking to streets in the bid to train for next year’s event or for shorter distance races. (more…)

Cracking the genetic code of cardiomyopathy in Egyptians

In the post, PhD student Mona Allouba, calls for a better understanding of the genetics of Egyptians in a bid for personalised treatments for cardiomyopathy patients

Over the past decade, several institutions in Egypt have been making huge scientific progress that is steadily reaching worldwide recognition. It is under these circumstances that I have been fortunate to join the Magdi Yacoub Foundation (MYF), which is recognised as one of Egypt’s most prominent charity organisations. The Aswan Heart Centre – located along the banks of the Nile in Aswan – is an integral part of MYF, offering state-of-the-art medical services for the underprivileged. It focuses on expanding the research on heart disease across the Middle East and beyond to contribute to the world’s scientific knowledge. (more…)