Lab Overview

The lab is an experimental medicine laboratory aiming to identifying new targets to treat cardiovascular disease.  We study how the autonomic nervous system contributes to the pathophysiology underlying hypertension and heart failure in humans. A particular focus is heart failure with preserved ejection fraction, a disease that currently has no treatment to improve life span.

Research Questions

There are several main areas of research that are on-going in the laboratory. First, we are interested in what causes excessive sympathetic drive and how this leads to hypertension. We think the brain might be essential in the development of hypertension and ask whether high blood pressure might be self-protection for the brain? Recently we found that in people with treated-controlled hypertension at rest, there is an excessive rise in blood pressure during exercise. We are now investigating whether we can improve the blood pressure response to exercise, in order to reduce residual risk of a cardiovascular event in these patients. This is related to our data that indicates the carotid body may be important in driving elevated blood pressure and that this may be a good target to improve blood pressure control at rest and during exercise. Finally, we are interested in whether the carotid body is linked to the development of heart failure preserved ejection fraction and whether targeting this organ can improve prognosis in these patients. 

Techniques

Dr. Hart's human research laboratory is situated in the Clinical Research and Imaging Centre-Bristol, which specialises in measuring sympathetic nerve activity directly from peripheral nerves in the body using a technique called microneurography. Other methodologies that the laboratory/group specialise in are measures of baroreflex and chemoreflex sensitivity, respiratory function, the exercise pressor reflex, arterial stiffness, cardiac and vascular function (using ultrasound and magnetic resonance imaging) and finally, exercise capacity.

Impact

The goal of the lab is to develop new targets and improve therapy in hypertension and heart failure. Currently, clinical trials of new medicinal products fail at high rates. Our experimental approach in humans aims to improve the translation of new targets into effective treatments. We have completed several clinical studies and trials; one of which has contributed to the development of a surgical device that might be used to help treat difficult to control hypertension.

Selected Publications

• Chant B, Bakali M, Hinton T, Burchell AE, Nightingale AK, Paton JFR, Hart EC. Anti-hypertensive treatment fails to control blood pressure during exercise. Hypertension. 2018: 102-109.
• Warnert EA, Rodrigues JC, Burchell AE, Neumann S, Ratcliffe LE, Manghat NE, Harris AD, Adams Z, Nightingale AK, Wise RG, Paton JF, Hart EC.Is high blood pressure self-protection for the brain? Circ Res. 2016: 140-151.
• Narkiewicz K, Ratcliffe LE, Hart EC, Briant LJ, Chrostowska M, Wolf J, Szyndler A, Hering D, Abdala AP, Manghat N, Burchell AE, Durant C, Lobo MD, Sobotka PA, Patel NK, Leiter JC, Engelman ZJ, Nightingale AK, Paton JF. Unilateral Carotid Body Resection in Resistant Hypertension: A Safety and Feasibility Trial. JACC Basic Transl Sci. 2016:313-324.
• Pijacka W, Moraes DJ, Ratcliffe LE, Nightingale AK, Hart EC, da Silva MP, Machado BH, McBryde FD, Abdala AP, Ford AP, Paton JF. Purinergic receptors in the carotid body as a new drug target for controlling hypertension. Nat Med. 2016:1151-1159.
• Briant LJ, Burchell AE, Ratcliffe LE, Charkoudian N, Nightingale AK, Paton JF, Joyner MJ, Hart EC. Quantifying sympathetic neuro-haemodynamic transduction at rest in humans: insights into sex, ageing and blood pressure control. J Physiol. 2016:4753-68

View complete publications list in the University of Bristol publications system.