Professor Melvin Lobo Specialist in Cardiovascular Medicine

Prof. 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^7-10.

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 regulation¹¹.

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.

Prof. Lobo has been awarded a £400 000 grant (from the Barts and The London Charitable Foundation) 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.

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

2012

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

2011

• William Harvey Research Institute Prize for Teaching Excellence

Taught Courses

02/2013, 02/2014, 02/2015

• Resistant Hypertension Course Berlin, Germany

Recent Invited lectures

12/06/2015

• European Society of Hypertension- Workshop on Multidrug intolerant hypertension

26/06/2014

• Innovations in Hypertension, London, UK – Medical strategies for resistant hypertension

20/05/2014

• EuroPCR Paris, France – Non renal targets for hypertension therapy

02/05/2014

• UK Kidney Week Glasgow, UK – Overview of device therapy of Hypertension

20/01/2014

• ISET Conference Miami, Florida – Newer technologies for Renal Denervation

02/12/2013

• ICI Meeting Tel Aviv, Israel – Renal Denervation Update

09/09/2013

• BHS Meeting London, UK – Device Management of Hypertension

01/09/2013

• ESC Congress Amsterdam, Netherlands – Developing consensus on renal denervation

Current Appointment:

• Consultant Cardiovascular Physician and Clinical Hypertension Specialist, Barts Health Trust
• Hon Senior Lecturer, NIHR Barts CV BRU, William Harvey Research Institute, Queen Mary University London

Positions of responsibility:

• Director Barts Blood Pressure Clinic
• Chief Investigator EnligHTN II study
• Chief Investigator ROX Coupler Study and ROX Global Registry
• Principal Investigator Symplicity HTN-2 Study
• Special Adviser to NICE: Renal Denervation/Baroreflex Activation
• ESH Working Group on Interventional treatment of Hypertension
• Steering Group UK National Registry for renal denervation
• Chair of the Bart’s Health Trust Joint Prescribing Group

Medical School:

• University of Manchester Medical School

Qualifications:

Graduate:

• 1989

  Bachelor of Medicine and Bachelor of Surgery MB ChB.

Post Graduate:

• 2015

  Fellow of the British Hypertension Society

• 2010

  Fellow of the Royal College of Physicians (FRCP London)

• 2000

  PhD Thesis (Vascular Biology), University of London

Registration:

• The General Medical Council (No: 3325506)

Specialty Training:

• Clinical Hypertension Specialist of the European Society of Hypertension
• Cardiovascular and General Internal Medicine
• Clinical Pharmacology & Therapeutics

Professional Memberships:

• Fellow of the Royal College of Physicians, London
• Fellow of the British Hypertension Society and member of the European Society of Hypertension
• Member of the British Pharmacological Society

Consultancy

• Advisory boards: Medtronic, St Jude Medical, Cardiosonic, ROX Medical
• Board Member: GiveBackBox^® (Los Angeles, California, USA)

06 May 2019

Daily mail.com

• Blast to kidney can end high blood pressure for good: How revolutionary 60-minute therapy could slash the risk of heart attacks and strokes
• ME & MY OPERATION: Blasts of soundwaves that mean you don't need your blood pressure pills

26 Sept 2015

Sky News – television

• Non-invasive renal denervation

23 May 2015

EuroPCR Congress Paris

• All you need to know session: Resistant Hypertension

ROX Coupler Jan 2015

CBS News – television

• Implantable device helps lower high blood pressure

BBC News:

• High blood pressure treatment device ‘promising’

The Independent

• ‘Revolutionary’ paperclip size device found to significantly lower high blood pressure

Times Online:

• ‘Paper clip’ implant can reduce blood pressure

Forbes:

• New Device To Lower Resistant High Blood Pressure Shows Early Promise

Renal Denervation

• Too early to say that renal denervation is a failed therapy
• London Chest Hospital trials device that ‘may cut blood pressure’
• Revolutionary operation could ‘cure’ high blood pressure
• Op that means you may never need to take a blood pressure pill again
• Blood pressure, Barts and kidney zapping

• Felix Mahfoud, Michael Böhm, Michel Azizi, Atul Pathak, Isabelle Durand Zaleski, Sebastian Ewen, Kostantinos Tsioufis, Bert Andersson, Peter J. Blankestijn, Michel Burnier, Gilles Chatellier, Sameer Gafoor, Guido Grassi, Michael Joner, Sverre E. Kjeldsen, Thomas Felix Lüscher, Melvin D. Lobo, Chaim Lotan, Gianfranco Parati, Josep Redon, Luis Ruilope, Isabella Sudano, Christian Ukena, Evert van Leeuwen, Massimo Volpe, Stephan Windecker, Adam Witkowski23, William Wijns, Thomas Zeller, Roland E. Schmieder. Proceedings from the European Clinical Consensus Conference For Renal Denervation – Considerations on Future Clinical Trial Design.

  European Heart Journal, 1–9.

• Tim J Brier, Ajay K Jain, Melvin D Lobo. Central Arteriovenous Anastomosis for hypertension – it’s not all about sympathomodulation. (accepted Future Cardiology Sept 2015)
• Lobo, M.D., Sobotka, P. A., Stanton, A., Cockcroft, J. R., Sulke, N., Dolan, E., et al. (2015). Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial.

  The Lancet.

• Lobo, MD, de Belder MA, Cleveland T, Collier DJ, Dasgupta I, Deanfield J, Kapil V, Knight C, Matson M, Moss J, Paton JFR, Poulter N, Simpson IA, Williams B, Caulfield MJ. Joint UK Societies 2014 Consensus Satement on Renal Denervation. Heart 2015;101:10-16 doi:10.1136/heartjnl-2014-307029
• Lobo, MD, Saxena M, Brier T, Kapil V. Resistant Hypertension Treatments – one size does not fit all. CrossTalk Debate – which technique for RHTN. Journal of Physiology Published online 29/10/2014
• Julu PO, Shah M, Delamont RS, Collier DJ, Wolff C, Saxena M, Brier T, Holdsworth L, Lobo MD. Response to CB Ablation: CrossTalk Debate – which technique for RHTN. Journal of Physiology Published online 29/10/2014
• Wolff, C., Collier, D., Shah, M., Brier, T., Kapil, V., Saxena, M., Lobo, MD. Regulation of blood flow and pressure. Advances in Experimental Medicine and Biology (in press)
• Kapil, V., Lobo, MD. Hypertension – pathogenesis, risk factors and prevention. Medicine 2014 (published online 22/07/2014: DOI;)
• Burchell, AE., Lobo, MD., Sulke, N., Sobotka, PA., Paton, JF. Arteriovenous Anastomosis: Is This the Way to Control Hypertension? Hypertension 2014; 64: 6-12
• Kapil, V., Jain, A.K., Lobo, M.D. Renal Sympathetic Denervation – a review of applications in current practice. Interventional Cardiology Review 2014; 9(1): 54-61.
• Lobo, MD. Renal sympathetic denervation: cautious optimism and careful next steps. Br J Cardiol; 2013; 20: 128-129
• Paton JF, Sobotka PA, Fudim M, Engelman ZJ, Hart EC, McBryde FD, Abdala AP, Marina N, Gourine AV, Lobo M, Patel N, Burchell A, Ratcliffe L, Nightingale A. Response to role of the carotid body in obesity-related sympathoactivation. Hypertension. 2013 Jun;61(6):e58
• Kapil V, Lobo MD. Clinical Considerations and the Potential for Renal Denervation. Endovascular Today; 2013; 10: 1-7
• Rajoo, S., Ng, F., Lobo, M. e-Learning to facilitate Prescribing Skills Assessment (PSA) preparation. Med Educ. 2013 May;47(5):520
• Paton, J.F.R., Sobotka, P.A., Hart, E., Burchell, A., Fudim, M., Engelman, Z.J., McBryde, F.D., Abdala, A.P., Marina, N., Gourine, A.V., Baumbach, A., Lobo, M., Partel, N., Nightingale, A. The Carotid body as a therapeutic target for treatment of sympathetically mediated diseases. Hypertension. 2013 Jan;61(1):5-13
• Caulfield, M., de Belder, M., Cleveland, T., Collier, D., Deanfield, J., Gray, H., Knight, C., Lobo, M., Matson, M., Moss, J., Poulter, N., Simpson, I., Tomson, C., Williams, B. Joint UK Societies 2011 Consensus Satement on Renal Denervation for Resistant Hypertension
• Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial Symplicity HTN-2 Investigators. The Lancet, 376;9756:1903 – 1909, (4 Dec 2010)
• Donaldson, J., Knowles, C., Hughes, F., Lobo, M. Rectus sheath haematoma associated with low molecular weight heparin: a case series. Ann R Coll Surg Engl. 2007Apr;89(3):309-12.
• Lobo, M. Combined formulations in hypertension. Current thinking Supplement, Prescriber Magazine July 2007
• Lobo, M. State of the Art: Hypertension. The Practitioner (2002) 246, 408-414
• Kabir, J., Lobo, M. Zachary, I. Staurosporine induces endothelial cell apoptosis via Focal Adhesion Kinase (FAK) dephosphorylation and focal adhesion disassembly independent of FAK proteolysis. Biochem. J. (2002) 367, 145-155
• Abu-Ghazaleh, R., Kabir, J., Jia, H., Lobo, M., Zachary, I. Src mediates stimulation by vascular endothelial growth factor of the phosphorylation of Focal Adhesion Kinase at tyrosine 861, and migration and anti-apoptosis in endothelial cells. Biochem. J. (2001) 360, 255-264
• Lobo, M., & Zachary, I. Nuclear localisation and apoptotic regulation of an amino-terminal domain focal adhesion kinase fragment in endothelial cells. Biochemical & Biophysical Research Communications, 276 (3):1068-1074, 2000 October 5
• Cospedal, R., Lobo, M., Zachary, I. Differential regulation of ERKs 1 and 2 by cAMP and dissociation of ERK inhibition from anti-mitogenic effects in rabbit vascular smooth muscle cells. Biochem J (1999) 342, 407-41

Published Abstracts/Oral Presentations

• Lobo, MD. The ROX Coupler: Adding Compliance and Reducing Resistance to the Arterial Tree: A Mechanical Treatment for Arterial Hypertension. Results of a Prospective, Randomized, Controlled, Blinded-Endpoint, Multicenter European Trial on Resistant Hypertension.

  Oral Presentation: TCT Sept 2014

• Worthley, SG., Montarello, J., Saxena, M., Jain, AJ., Walters, D.,Pincus, M., Lobo, MD. Safety and Performance of the EnligHTN Renal Denervation System in Patients with Uncontrolled Hypertension: 1 Month Results of the First 100 Patients in the EnligHTN II Study.

  Oral Presentation: European Society of Hypertension June 2014

• Lobo, MD., Montarello, J., Saxena, M., Jain, AJ., Walters, D.,Pincus, M., Worthley, SG. Renal Sympathetic Denervation System in Patients with Anti-hypertensive Medication Intolerance and Uncontrolled Hypertension: 1 Month Results of the EnligHTN II Study

  Poster Presentation: European Society of Hypertension June 2014

• Chan, K., Ng, F., Saxena, M., Collier, D., Matson M, Jain A., Caulfield, M., Lobo, M. Heterogeneous and modest response to renal denervation in resistant hypertension – a prospective case series

  Oral Presentation: European Society of Hypertension June 2013

• Chan, K., Ng, F., Saxena, M., Collier, D., Matson M, Jain A., Caulfield, M., Lobo, M. Renal Denervation for resistant hypertension – a prospective case series

  Poster Presentation: British Hypertension Society Sept 2012

• Saxena, M., Collier, D., Caulfield, M., Lobo, M. Resistant hypertension and salt restriction

  Oral Presentation: British Hypertension Society Sept 2012

• Lidder, S., Ng, F., Gulati, R., Whitehand, A., Perry, L., Lobo, M. Can renin measurement be extended to primary care to inform the stratified medicines approach to hypertension therapy?

  Oral Presentation: British Hypertension Society Sept 2012

• Rajoo,S., Lobo, M Interactive e-learning to improve intravenous fluid prescribing skills

  Poster Presentation: AMEE Conference August 2012

• Rajoo,S., Ng, F., Lobo, M. A novel electronic learning tool to facilitate preparation for the Prescribing Skills Assessment

  Oral Presentation: Association for the Study of Medical Education July 2012

• Rajoo,S., Ng, F., Lobo, M. A novel electronic learning tool to facilitate preparation for the Prescribing Skills Assessment.

  Electronic resource contribution: Higher Education Academy Health Sciences 2012 conference

• Lidder, S., Ng, F., Gulati, R., Whitehand, A., Perry, L., Lobo, M. Chilling of blood samples for plasma renin activity is not essential – a comparative study

  Poster Presentation: ESH 2012

• Patel, S., Uddin, I., Ward, A., Ng, F., Caulfield, M., Lobo, M. Plasma renin activity in the South Asian population – an intermediate group

  Oral Presentation: British Hypertension Society Sept 2011

• PO Julu, M Matson, I Renfrew, MD Lobo A case of failed renal denervation – can autonomic function tests be used to predict response to treatment?

  Poster Presentation: BHS Meeting 2011

• S. Patel, I. Uddin, A. Ward, F.L. Ng, M.J. Caulfield, M.D. Lobo Salt intake in hypertensive patients with at or above-target blood pressures

  Oral Presentation: British Hypertension Society Sept 2011

• Rull, G., Arunachalam, G., Wadley, J., Mandersloot, G., Lobo, M. Severe uncontrolled hypertension treated with microvascular decompression of the brainstem.

  Oral Presentation: British Hypertension Society Sept 2007

• Arunachalam, G., Emery, M., Lobo, M. A rugby player with collapse.

  Oral presentation: European Federation of Internal Medicine 2007

• Lobo, M., Ravic, N., Forte, P,. Milne, E., Lewis, G., Webb, A., Hedges, A.M., Benjamin, N. Effect of Quinapril and Losartan on Nitric Oxide Synthesis in Patients with Essential Hypertension. American Society of Hypertension. 2004.
• Lobo, M., Zachary, I. Subcellular compartmentalisation, site-specific tyrosine phosphorylation and apoptotic proteolysis of Focal Adhesion Kinase in Human Umbilical Vein Endothelial Cells. Mol. Biol. Cell 1999 10:S, 335a
• Lobo, M., Zachary, I. Constitutive nuclear localisation of Focal Adhesion Kinase in rabbit vascular smooth muscle cells. British Society for Cardiovascular Research. 1998
• Lobo, M., Zachary, I. Increased protein expression of focal adhesion components during early stages of smooth muscle cell explant culture. 10th International Vascular Biology Meeting. 1998

Case Reports

• Ghadiri-Sana, M., Mann, I., Lobo, M., Jawad, A. Secondary syphilis presenting as palmoplantar psoriasis. J R Coll Physicians Edinb 2008; 38:215–7
• Everett, CM., Turner, B., Lobo, M. Posterior reversible encephalopathy syndrome in (low renin) essential hypertension. J R Soc Med. 2007 Nov;100(11):522-3.

Book Chapters

• Contributing author: Cardiovascular Sections (12 chapters), French’s Index of Differential Diagnosis, 15th Edition Eds. Kinirons and Bouchier. (Published 28/01/2011)
• Contributing author: Cardiovascular Sections (12 chapters), French’ Index of Differential Diagnosis (14th Ed. Published 25/11/2005) Eds. Kinirons and Bouchier.

Excellence in Clinical Practice

Prof. Lobo is the Director of the internationally renowned Bart’s Blood Pressure Clinic which has been recognised as a Hypertension Centre of Excellence by the European Society of Hypertension and receives referrals of complex hypertensive patients on a national and international basis. The clinic is allied to the world renowned William Harvey Research Institute and has participated in several landmark studies in hypertension. These include the ground-breaking ASCOT study which led to a change in UK Hypertension guidelines as well as the Symplicity HTN-2 study of renal denervation for treatment-resistant hypertension^1,2 and most recently the ROX Control Hypertension Study of a novel central iliac arteriovenous anastomosis to treat uncontrolled hypertension³.

Since October 2011 he has co-hosted and chaired the annual UK Symposia on Renal Denervation at the Royal College of Physicians with a distinguished panel of international authorities in hypertension medicine and interventionists.

Prof. Lobo is a member of the Joint British Societies steering committee on renal denervation and author of the JBS Consensus Statements on Renal Denervation4,5. He has lectured and published extensively on hypertension and novel therapies of resistant hypertension⁶.

Research Excellence

Prof. 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^7-10.

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 regulation¹¹.

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:

Prof. Lobo has been awarded a £400 000 grant (from the Barts and The London Charitable Foundation) 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.

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 conferences¹².

1. Teaching prizes
   • William Harvey Research Institute Prize for Teaching Excellence 2012
   • NHS Teachers Award 2012
   • William Harvey Research Institute Prize for Teaching Excellence 2011
2. Taught Courses
   • Resistant Hypertension Course Berlin
     Germany 02/2013, 02/2014, 02/2015
3. Recent Invited lectures
   • European Society of Hypertension – Workshop on Multidrug intolerant hypertension, 12/06/2015
   • Innovations in Hypertension, London, UK – Medical strategies for resistant hypertension, 26/06/2014
   • EuroPCR, Paris, France – Non renal targets for hypertension therapy, 20/05/2014
   • UK Kidney Week, Glasgow, UK – Overview of device therapy of Hypertension, 02/05/2014
   • ISET Conference, Miami, Florida – Newer technologies for Renal Denervation, 20/01/2014
   • ICI Meeting, Tel Aviv, Israel – Renal Denervation Update, 02/12/2013
   • BHS Meeting, London, UK – Device Management of Hypertension, 09/09/2013
   • ESC Congress, Amsterdam, Netherlands – Developing consensus on renal denervation, 01/09/2013

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.
12. Rajoo SG, Ng FL, Lobo M. e-Learning to facilitate preparation for prescribing skills assessment. Medical education 2013; 47(5): 520.