Excellence in Clinical Practice

Professor Melvin Lobo is a Consultant Cardiovascular Physician based in the Barts Heart Centre and the William Harvey Research Institute. He has a specialist interest in blood pressure disorders of all types, autonomic control of the circulation and also resistant hypertension and device-based therapies thereof. He is an accredited Clinical Hypertension Specialist of the European Society of Hypertension (ESH) and British Hypertension Society.

Professor Lobo is Director of the Bart's Blood Pressure Clinic which is a Hypertension Centre of Excellence and receives referrals of patients with complex circulatory disorders on a national/international basis and has contributed to several landmark studies in hypertension, particularly in the field of novel device therapy of hypertension. His research work has been featured on television and in the national press on numerous occasions (see website for details).

In addition to hypertension, he is also an acknowledged expert in the management of low blood pressure (hypotension) and BP variability disorders and PoTS (postural tachycardia syndrome) and sees patients on a national basis with these issues in the Barts BP Clinic and on an international basis in his private practice. He has the largest cohort of medication intolerant patients nationally and has evolved, published and lectured on specialised strategies with liquid and patch formulations of antihypertensives to get around intolerances to tablets.

He is recognised globally as a key opinion leader in his field and this is reflected in numerous roles in multicentre clinical trials, invited lectures at major conferences and also as an editor/reviewer of numerous journals including JACC and Lancet. More recently he has authored national and co-authored international guidelines for device therapy of hypertension which were published in the prestigious European Heart Journal.

He organises and co-chairs the UK Annual Symposia on Device Therapy of Hypertension with a distinguished panel of international authorities in hypertension medicine. He is a specialist adviser to NICE and the European Society of Hypertension on interventional therapies in hypertension and a member of the Council on Hypertension of the European Society of Cardiology.

Research Excellence

Professor Lobo has developed three major research themes in thee Barts Blood Pressure Clinic which he leads on.

  1. Device therapy of Hypertension.

    As Chief or Principal investigator of numerous studies in the field of resistant hypertension, Prof Lobo continues to strive to bring new therapies to the hypertension clinic which are safe and effective

  2. Phenotyping of complex hypertension

    Prof Lobo has set up an autonomic and cardiovascular haemodynamic laboratory to study the role of sympathetic nervous signalling in hypertension and circulatory regulation

  3. Multi-drug intolerant patients

    A further major interest of his group is in the management of patients with multiple drug intolerances who are unable to take conventional antihypertensive medications and thus pose a real challenge to clinicians. Exciting preliminary data from this cohort of patients indicates that a stratified medicines approach using fractional tablet dosing, liquid antihypertensives and patch formulations of antihypertensive drugs can achieve significant BP lowering in this high risk patient group

Grants:

2017: £500 000 (The Barts Charity) to incept a sole UK centre for baroreflex activation therapy at the Barts Heart Centre aiming to treat patients with uncontrolled hypertension and those with BP variability disorders due to afferent baroreflex failure.

2012: £400 000 (The Barts Charity) to study the effects of renal denervation on blood pressure and autonomic function in patients with chronic kidney disease and patients who are intolerant of anti-hypertensive medications.

Advisory Boards & Consultancies:

  • Medtronic Renal Denervation Advisory Board (from 2009 onwards)
  • St Jude Medical Global Advisory Board (2011-2017)
  • ROX Medical from 2013-2018
  • Tarillian Laser Technologies Consultant (2014-2019)
  • KONA Medical (2014-2017), CVRx (2016 onwards),
  • Vascular Dynamics, ReCor Medical, Ablative Solutions (from 2017 onwards)
  • Aktiia, Vastmindz, Probiometrics (from 2020 onwards)

Teaching Excellence

Prof Lobo is a highly regarded medical educator and teacher as evidenced by a number of teaching prizes and invitations to teach on prestigious courses as well as speaker engagements at key national and international conferences.

Teaching prizes

  • William Harvey Research Institute Prize for Teaching Excellence 2012
  • NHS Teachers Award 2012
  • William Harvey Research Institute Prize for Teaching Excellence 2011

Taught Courses

  • Resistant Hypertension Course Berlin, Germany 02/2013, 02/2014, 02/2015

References

  1. Symplicity HTNI, Esler MD, Krum H, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 2010; 376(9756): 1903-9.
  2. Lobo MD. Renal sympathetic denervation: cautious optimism and careful next steps. Br J Cardiol; 2013.
  3. Lobo MD, Sobotka PA, Stanton A, et al. Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial. Lancet 2015.
  4. Lobo MD, de Belder MA, Cleveland T, et al. Joint UK societies’ 2014 consensus statement on renal denervation for resistant hypertension. Heart 2015; 101(1): 10-6.
  5. Caulfield M, de Belder M, Cleveland T, et al. Joint UK Societies’ Consensus Summary Statement on Renal Denervation for Resistant Hypertension 2011. (accessed)
  6. Kapil V, Lobo M. Hypertension – pathogenesis, risk factors and prevention. Medicine 2014.
  7. Kapil V, Lobo MD. Clinical Considerations and the Potential for Renal Denervation. Endovascular Today, Oct 2013, 2013. (accessed).
  8. Kapil V, Jain AK, Lobo MD. Renal Sympathetic Denervation – A Review of Applications in Current Practice. Interventional Cardiology Review 2014; 9(1): 54-61.
  9. Burchell AE, Lobo MD, Sulke N, Sobotka PA, Paton JF. Arteriovenous anastomosis: is this the way to control hypertension? Hypertension 2014; 64(1): 6-12.
  10. Paton JF, Sobotka PA, Fudim M, et al. The carotid body as a therapeutic target for the treatment of sympathetically mediated diseases. Hypertension 2013; 61(1): 5-13.
  11. Wolff C, Collier D, Shah M, et al. Regulation of blood flow and pressure. Advances in Experimental Medicine and Biology in press.