Latest news with #ImperialCollegeLondon
Business Standard
8 hours ago
- Health
- Business Standard
TOPSPIN Study by the Centre for Chronic Disease Control (CCDC) Finds Two-drug Combination Therapies Effective in Improving Blood Pressure Control in Indians
NewsVoir New Delhi [India], July 30: A new study, entitled TOPSPIN, coordinated by the Centre for Chronic Disease Control (CCDC) New Delhi, in collaboration with the All India Institute of Medical Sciences (AIIMS) New Delhi, and Imperial College London, examined 1,981 patients with uncontrolled hypertension across 32 hospitals in India. The findings showed that three two-drug combination therapies - Amlodipine plus Perindopril, Amlodipine plus Indapamide, and Perindopril plus Indapamide - were equally effective and safe in lowering both ambulatory and office blood pressure. TOPSPIN is the first-ever randomised study to test the choice of first-line two-drug combination therapy in a single pill among South Asians. The study findings are published in Nature Medicine, one of the top medicine journals. South-Asians represent one-fourth of the world population, and India alone constitutes one-sixth of the global population. Hypertension is a public health crisis affecting over one billion adults worldwide, including over 300 million living in India. Innovative solutions are needed to curb the growing tide of high blood pressure, which is the single highest risk factor for global deaths, and which requires effective management solutions. Current guidelines widely recommend initiating treatment with two-drug combinations, preferably in a single-pill formulation, to enhance blood pressure control. However, the suitability of these combinations for the South-Asian population remains unknown, as there are no studies in this regard. The key takeaways are that all three combinations were equally effective in reducing blood pressure and were safe for patients. What did the TOPSPIN study find? - Blood pressure dropped significantly after 6 months, by around 14/8 mmHg when measured over 24 hours and about 30/14 mmHg in clinic settings. - Nearly 70% of patients reached the recommended blood pressure target below 140/90 mmHg, five times higher than India's current average control rate. - The pills were well-tolerated, with less than 3% of patients reporting side effects serious enough to stop treatment. What do the Study leaders say? "This study shows that a single daily pill with two drugs can be a simple and powerful way to manage blood pressure in Indian and South Asian patients," said Prof. Dorairaj Prabhakaran, Executive Director of CCDC and one of the study's lead authors. "These findings can help guide doctors and policymakers. If added to India's list of essential medicines and made available at primary health centres, these pills could greatly improve blood pressure control in the country." Prof. Ambuj Roy, Professor of Cardiology at AIIMS Delhi, added, "Nearly 70% of patients got their blood pressure under control, a huge improvement over the current national average. And the pills were safe and easy to use. This study gives clear guidance for better hypertension care." Prof. Neil Poulter, Professor at Imperial College London, emphasized the importance of studying how medicines work in different populations. "Just as earlier research in Africa showed different results, this study gives strong evidence on what works best in South Asians." The TOPSPIN study results could help improve treatment not only in India, but also for South Asians living around the world.
Fashion Value Chain
10 hours ago
- Health
- Fashion Value Chain
TOPSPIN Study by the Centre for Chronic Disease Control (CCDC) Finds Two-drug Combination Therapies Effective in Improving Blood Pressure Control in Indians
A new study, entitled TOPSPIN, coordinated by the Centre for Chronic Disease Control (CCDC) New Delhi, in collaboration with the All India Institute of Medical Sciences (AIIMS) New Delhi, and Imperial College London, examined 1,981 patients with uncontrolled hypertension across 32 hospitals in India. The findings showed that three two-drug combination therapies – Amlodipine plus Perindopril, Amlodipine plus Indapamide, and Perindopril plus Indapamide – were equally effective and safe in lowering both ambulatory and office blood pressure. TOPSPIN is the first-ever randomised study to test the choice of first-line two-drug combination therapy in a single pill among South Asians. The study findings are published in Nature Medicine, one of the top medicine journals. A doctor checking the blood pressure of a patient South-Asians represent one-fourth of the world population, and India alone constitutes one-sixth of the global population. Hypertension is a public health crisis affecting over one billion adults worldwide, including over 300 million living in India. Innovative solutions are needed to curb the growing tide of high blood pressure, which is the single highest risk factor for global deaths, and which requires effective management solutions. Current guidelines widely recommend initiating treatment with two-drug combinations, preferably in a single-pill formulation, to enhance blood pressure control. However, the suitability of these combinations for the South-Asian population remains unknown, as there are no studies in this regard. The key takeaways are that all three combinations were equally effective in reducing blood pressure and were safe for patients. What did the TOPSPIN study find Blood pressure dropped significantly after 6 months, by around 14/8 mmHg when measured over 24 hours and about 30/14 mmHg in clinic settings. Nearly 70% of patients reached the recommended blood pressure target below 140/90 mmHg , five times higher than India's current average control rate. The pills were well-tolerated, with less than 3% of patients reporting side effects serious enough to stop treatment. â What do the Study leaders say 'This study shows that a single daily pill with two drugs can be a simple and powerful way to manage blood pressure in Indian and South Asian patients,' said Prof. Dorairaj Prabhakaran, Executive Director of CCDC and one of the study's lead authors. 'These findings can help guide doctors and policymakers. If added to India's list of essential medicines and made available at primary health centres, these pills could greatly improve blood pressure control in the country.' Prof. Ambuj Roy, Professor of Cardiology at AIIMS Delhi, added, 'Nearly 70% of patients got their blood pressure under control, a huge improvement over the current national average. And the pills were safe and easy to use. This study gives clear guidance for better hypertension care.' Prof. Neil Poulter, Professor at Imperial College London, emphasized the importance of studying how medicines work in different populations. 'Just as earlier research in Africa showed different results, this study gives strong evidence on what works best in South Asians.' â The TOPSPIN study results could help improve treatment not only in India, but also for South Asians living around the world.
Telegraph
10 hours ago
- Science
- Telegraph
First woman appointed Astronomer Royal
A woman has been appointed Astronomer Royal for England for the first time in history. Prof Michele Dougherty will take on the prestigious role after the retirement of Lord Martin Rees, who held the position for 30 years. The title Astronomer Royal has been awarded to a leading expert in the field for 350 years, and has had 15 separate holders in this time. The honorary role involves a duty to inform the monarch of astronomical matters. The position was first created in the 17th century by Charles II as a way to discover a way to determine longitude at sea when out of sight of land, 'for perfecting the art of navigation'. John Flamsteed, a Derbyshire astronomer, was the inaugural Astronomer Royal and also made the first recorded observations of Uranus. He laid the foundation stone of the Royal Observatory in Greenwich, where the Astronomer Royal is based to this day. 'I am absolutely delighted to be taking on the important role of Astronomer Royal,' said Prof Dougherty. 'As a young child I never thought I'd end up working on planetary spacecraft missions and science, so I can't quite believe I'm actually taking on this position. 'In this role I look forward to engaging the general public in how exciting astronomy is, and how important it and its outcomes are to our everyday life.' Prof Dougherty is professor of space physics at Imperial College London, and her research focuses on the magnetic field interactions of planets, especially those of the gas giants, Saturn and Jupiter. She was the principal investigator of the magnetometer on Nasa's Cassini spacecraft mission, which analysed data of Saturn's magnetic field. Prof Dougherty's work led to the discovery of water vapour around the Saturnian moon Enceladus, thereby showing it could harbour life. Prof Dougherty also worked on the Galileo mission to Jupiter, and the current Juice mission to the Jovian moons Europa, Callisto and Ganymede, which is scheduled to arrive in 2032. When Juice launched in 2023, she said the project was trying to detect tiny magnetic fluctuations, which is 'like trying to find lots of needles in a haystack, and those needles are changing shape and colour all the time'. She has been instrumental in furthering humanity's knowledge of the solar system and is highly decorated with awards and recognition, including the Hughes Medal, a CBE, and being elected as a Fellow of the Royal Society. Women in Stem Prof Dougherty has also spoken about the importance of inclusion and diversity in science, particularly around the value of women in Stem fields. In 2022, she criticised headteacher Katharine Birbalsingh for saying that girls shun physics at A-level because of an aversion to 'hard maths'. Prof Dougherty said at the time: 'We have worked incredibly hard in the UK in recent years to ensure that anyone who is interested in studying physics feels supported and enabled to do so, and this is something we will continue to focus on. 'I am so very proud of all that my students and staff achieve as they carve out their careers – irrespective of their gender. It is astounding to me that senior leaders in the UK continue to make such unbelievably stereotypical comments, which are not backed up by data.' Prof Dame Angela McLean, the Government Chief Scientific Adviser, said: 'Warm congratulations to Prof Michele Dougherty on her appointment to the distinguished position of Astronomer Royal. This is a fitting recognition of her outstanding work and enduring commitment to the field of astronomy.'
Daily Mirror
4 days ago
- Climate
- Daily Mirror
Met Office's brutal 40C heatwave verdict as UK climate 'escalates'
Following a series on intense heat spells, the Met Office have warned that UK heatwaves are about to get longer and hotter in the coming years - risking dangerously high temperatures of up to 40C Brits have been urged to brace for hotter and longer heatwaves, following alarming new data from the Met Office. The UK has been sweltering under sky-high temperatures in recent weeks thanks to a series of intense hot spells. In fact, last month was the warmest June on record in England, and the second warmest in the UK since records began back in 1994. Then, on July 1, the UK experienced its hottest day of the year, with St James' Park in London reaching a scorching 34.7C. While the balmy temperatures and blue skies were dramatically quashed this week thanks to heavy rain and thunderstorms that battered huge parts of the nation - it seems Britain is set to bask in the sunshine once again. Temperatures reaching up to 27C are expected to return to multiple towns and cities this weekend. While the odd heatwave (especially one that lands on a weekend) may be appreciated by pasty Brits wanting to top up their tan, experts are concerned about the frequency of these extreme conditions. Heatwaves have been linked with thousands of deaths in recent years - with a staggering 2,295 people dying due to five periods of heat across the summer of 2023. Last month, a rapid analysis found that the UK's intense heat spell will 'likely' kill almost 600 people in England and Wales. "Heatwaves are silent killers – people who lose their lives in them typically have pre-existing health conditions and rarely have heat listed as a contributing cause of death," said Dr Garyfallos Konstantinoudis, at Imperial College London. As a result, Met Office scientists have recently published a shocking study revealing the chance of temperatures exceeding 40°C in the UK is accelerating at pace. The UNSEEN study uses a global climate model to create a 'large set of plausible climate outcomes in the current climate'. This allows experts to predict the current risk and how extremes have changed over the last few decades. "The chance of exceeding 40°C has been rapidly increasing, and it is now over 20 times more likely than it was in the 1960s," Dr Gillian Kay, Senior Scientist at the Met Office, and lead author of the study states. "Because our climate continues to warm, we can expect the chance to keep rising." The study concluded that there is now a 50-50 chance of seeing another 40C day again in the next 12 years in the UK. "We also found that temperatures several degrees higher than we saw in July 2022 are possible in today's climate," Dr Kay added. Dr Nick Dunstone, Met Office Science Fellow and co-author of the study, warned that UK heatwaves are also becoming longer. "The well-known hot summer of 1976 had more than a fortnight above 28°C, which is a key heatwave threshold in southeast England," he explained. "Our study finds that in today's climate such conditions could persist for a month or more. These findings highlight the need to prepare and plan for the impacts of rising temperatures now, so we can better protect public health, infrastructure, and the environment from the growing threat of extreme heat."
Telegraph
5 days ago
- Health
- Telegraph
Robert Winston: ‘Striking doctors have lost the plot and the trust of the nation'
Robert Winston's impeccable bedside manner does not lend itself to expressions of anger, but there is no mistaking his disgust as he decries the 'highly immoral' doctors' strike beginning on Friday. After six decades in medicine, Prof Lord Winston is better qualified than almost anyone in the country to assess the current state of the NHS and the impact the strike will have on it and its patients. There is no doubt in his mind that people will die as a result of the five-day walkout – for which he cannot forgive his colleagues – but he foresees a much longer-term malaise taking root in the NHS because of the industrial action. 'I think it's very, very obvious that my colleagues, the resident doctors, have lost the plot, and more importantly probably lost the trust of the nation,' he says, 'and I think it's going to be very difficult to get that back.' A professor of science and society at Imperial College London, Lord Winston is a fertility expert who pioneered key advancements in IVF treatment. However, it was the groundbreaking BBC documentary series he presented – including Your Life in Their Hands, The Human Body and Child of Our Time – that made him a household name. He is also a Labour peer. Celebrated for his calm, authoritative persona, which remains steady even during a clinical dissection of his younger colleagues' behaviour, his message becomes all the more powerful. Earlier this month, he resigned his membership of the British Medical Association (BMA) after 61 years, mainly due to his disgust at the proposed strikes, but also because of its failure to tackle rising anti-Semitism among NHS doctors, of which more follows. The strike is an attempt by the BMA to force the Government into giving residents (previously known as junior doctors) a pay rise of 29 per cent, on top of increases of 22 per cent and 5.4 per cent over the past three years. Lord Winston does not mince his words when I ask him how much danger patients will be in because of the strike. 'It's very likely if this lasts at all long, somebody will die,' he says. 'Inevitably they will. You can't avoid it. 'Several people clearly are going to have much worse chances of getting their cancers treated, and some people will be less well or in pain. You can't simply allow disruption of services on this scale, and not accept the fact that more accidents will happen.' Trust in the NHS will be eroded, and Lord Winston believes that trust is not only important in determining the level of public support for the strikes but also has a direct effect on patients' health. 'That is an important part of treatment because if people trust you and they feel they're getting good medicine, they tend to get better because of what we call a placebo effect, which actually is not insignificant,' he says. 'It's been shown again and again that that attitude to your medicine plays a major role in how you heal. If you're reasonably happy and reasonably sure of your treatment, what studies have shown is that your symptoms get less and your treatment tends to be quicker.' The doctors' union, Lord Winston says, 'does not represent a very large proportion of the medical profession' anymore, and is 'acting highly politically' under the chairmanship of Dr Thomas Dolphin, a militant Corbynista who tried, and failed, to be selected as a Labour Party candidate at the last election. Lord Winston is not convinced that the strikes have as much support among resident doctors as it might seem; he believes many have been 'pressurised' into backing strike action by a union attempting to 'blackmail' the Government. 'At this time when people are struggling in all walks of life, in all professions, particularly with the difficult financial situations we have, I think that's pretty dishonourable. But more importantly, I don't think doctors should strike.' Lord Winston is now 85 but still has a full head of dark hair and a jet-black moustache, and retains all the sharpness and vigour of a man half his age. 'It's probably all genes,' he chuckles when I ask how he stays looking so young. 'I don't live particularly well. I drink too much alcohol.' He is speaking from the kitchen of his home in north-west London, where he lives alone following the sudden death of his wife Lira four years ago, after 48 years of marriage. Lord Winston obtained his medical degree in 1964 and made a career as an expert in fertility. As professor of fertility studies at Hammersmith, he led the IVF team that pioneered pre-implantation genetic diagnosis to identify defects in human embryos. He remains professor of science and society at Imperial College London and its emeritus professor of fertility studies, and is a founding member of the UK-Israel Science Council. He is old enough to remember the formation of the NHS, has worked within it for most of its history, and is not afraid to say that it needs to change to survive. He points out that when the NHS was founded in 1948, the per-patient cost each year was around 10s 6d, which translates to about £100 in 2025, adjusted for inflation. Today's per-patient cost is around £3,000, meaning it is time to discuss a new way of funding the NHS, Lord Winston says. He does not offer a ready-made alternative funding model, but says that if the NHS were a factory producing goods, the manager would know the cost price of everything it did, whereas 'we don't know any of that in the NHS'. The biggest cost within the NHS, of course, is wages, and student doctors entering the profession today need to be realistic about what to expect, both in terms of pay and conditions when they first begin working, he suggests. 'When I talk to medical students, which I do very frequently, I make it very clear that the NHS is not an easy place to work in,' he says. 'When I first got on the wards, I made a terrible mistake on the first day – almost killed a patient by injecting something. 'I say, look, this is difficult, but in the long term it's still worth doing.' Successive governments are partly to blame for the current dissatisfaction among some NHS staff, he says, but from a financial point of view, medicine remains a lucrative profession for doctors who rise through the ranks. 'I didn't get my first house until 10 years after I qualified. It is a problem, but in the long term it's a pretty secure job and you can do a lot of things with it. And you can earn in all sorts of ways if you want to.' Despite being a Labour peer with expertise in health, he says he has never met Wes Streeting, the Health Secretary, but believes 'he is absolutely right to be looking at all sorts of options' to end the doctors' dispute. Streeting thinks there is a deal to be done on the cost of exams, equipment and training. Lord Winston says he does not understand why the doctors refuse to consider the offers being made, unless the BMA is purely motivated by a desire to challenge the Government – 'and I think that's a dangerous thing to do.' Another way in which the BMA appears to have become politicised, he says, is over the issue of anti-Semitism in the workplace. Lord Winston, who was brought up as an Orthodox Jew, says this was part of the reason he quit the BMA. Some Jewish doctors have reported feeling 'intimidated and unsafe' at the BMA's annual conference because one in 10 motions relate to Israel, Palestine or Zionism. The union has also been accused of allowing members to cross the line from expressing political opinions into singling out Jewish colleagues. Is that fair criticism? 'I've had a number of letters from colleagues who have raised that issue with me,' he says. 'There are lots of areas where the BMA is failing. Anti-Semitism certainly is something that I know a lot of Jews have been worried about, and sometimes I've seen pretty horrific things that are still going on and not properly dealt with.' He says one of the problems he keeps hearing complaints about is NHS workers conflating being Jewish with being Israeli, meaning 'you're responsible for the Israeli government and the appalling things which are happening in the Middle East'. 'I've seen many people who've been very unpleasantly criticised for something which is no fault of theirs simply because they're Jewish.' He has come to the conclusion that the BMA, which has not even bothered responding to his attempts to engage with it, is 'not fit for purpose'. Last year, Dr Dolphin put forward a motion, passed without debate, to reject the independent Cass review into children's transgender services, which called on the NHS to stop prescribing puberty blockers to minors. Lord Winston, who believes people cannot change their biological sex through surgery or any other means, was an outspoken supporter of the gender-critical academic Kathleen Stock, who was sacked by the University of Sussex in 2021. 'The BMA haven't done very well on that either,' Lord Winston says. 'They've ended up with a very muddled appraisal of transgender, which doesn't make any kind of scientific sense. And of course, transgender is a massive problem because people who are transgender are now really quite at risk. 'How we deal with this, of course, has to be a scientific solution to some extent until we understand why people want to be transgender or end up being transgender […] I know from my own clinic I saw quite a few patients who had changed their sex, or had transgender procedures, who then regretted what had happened later on. 'One of the things we do need to have is real sensitivity towards people who are in this situation, and towards the families too, who often have difficult relationships with their own children as a consequence. That needs to be dealt with. I don't think the BMA has made a great attempt at doing that. 'It would be very helpful if we had a proper discussion which is based more on the science and the medicine than the attitudes.' Another emotive subject facing politicians at the moment is assisted dying. Kim Leadbeater MP's bill to legalise it is currently on its way through the House of Lords, and Lord Winston will be speaking when it is debated later this year. He says that, having initially been against the bill, he is now leaning towards supporting it. 'I'm massively coming around to the fact that we're behind the curve in this country because […] there are many, many countries now that have some form of legislation. 'And it seems to me that there are certain situations where people really have a right to take some kind of elixir that, in fact, allows them to be finally free of pain. 'Of course, I want to see more palliative care, but one of the problems is that many of those most opposed have strong religious views. That's a dangerous position to take if you're a parliamentarian, because you're legislating for the whole community, not just people of your own faith.' For that reason, he abstained from the last vote on the bill in the Lords, but says he has tried to imagine what he would want if he were in the position of terminally ill patients seeking control over their own death. He draws on personal experience, recalling his time working for a GP to earn extra money during holidays from his hospital residency. The GP told him that a terminally ill lung cancer patient must not be admitted to hospital under any circumstances 'because he wants to stay in his own surroundings'. Lord Winston was told to visit the man every day, and in the end 'he died very peacefully' in his own home. He also brings up the case of Herbie Mowes, the German antiques dealer who made history by allowing the BBC to film his death from cancer for Lord Winston's documentary series The Human Body in 1998. The BBC, he recalls, 'wanted to abandon the programme' after the press derided it as a 'snuff video,' but after it was broadcast, it helped to change attitudes towards death, he says. Herbie 'was content with his garden, his little house, and his friends,' and his GP visited twice a week to adjust his medication. A large crew worked on the documentary, he says, and 'I think they often changed their view about dying afterwards'. It would be remiss not to ask the country's foremost expert on fertility for his views on the latest developments in IVF and genetics. When I ask him for his views on this month's controversy over 'three-parent babies'– in which the nucleus of a fertilised egg is transferred into a donor egg to avoid a type of genetic disease – he points out that he fought for the procedure to be legalised during a Lords debate a decade ago. He dismisses criticism of the procedure, which has been pioneered by Newcastle University, saying that it is only really the 'battery pack' in human cells that is being altered. But it does raise a much wider question: would it be right for science to eradicate disability altogether if it were possible? 'No,' he says, 'but we couldn't, because when it comes to genetic disease, many genetic diseases occur between generations. 'So we're going to continue to get genetic disease, even with screening, even with the ability to change DNA in embryos.' The future of medicine, he says, 'is not really in our genes, it's in how we improve people's environment'. Better education and higher living standards, he believes, will have a greater impact on world health than the DNA inside embryos. As for his own living standards, he mentions that he could have chosen to settle in America, where he was paid 'a huge salary' with much better funding for his research during a spell there in the early 1980s, but he cannot live without London's art galleries and its classical music and opera scene. His other passion in life, aside from his three grown-up children and eight grandchildren, is his wine collection, which he started building up as an undergraduate, with a particular love of burgundies – 'unpredictable and often unrepeatable,' in his words. 'I recently drank one from 1919,' he says, 'which I bought for a couple of quid a long time ago and which would now be valuable at auction. 'But I'm not interested in trying to sell wine. What I like is to sit around and drink it with friends.' Likewise, Winston's medical career has never been about the money – and he seems to wish that today's resident doctors would adopt the broader view that has guided him throughout his career. He believes that 'doctors have a huge moral obligation'. 'They're sitting in front of somebody they don't know very well,' he says, 'but who is actually opening themselves up in a very private way, in a way they don't really want to. 'They're often in pain. They're often very worried. They often think they have something much worse than they really do. They're about to undergo all sorts of humiliating tests and investigations. They're in hospital, away from their family. They're worried about money, they're worried about their family. 'A doctor has a unique privilege. Nobody else in the world has that privilege. And I want to say that to them because, if you abuse that privilege, you run great risks with the relationship you then have with the patient afterwards.'
