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Device to measure central BP, improved chest pain tests touted… and could a vaccine bring an end to Delhi belly?

In the news this morning, the BBC reports that a wrist sensor can provide a more accurate measure by calculating central blood pressure after monitoring a patient’s pulse pressure over 24 hours.

UK researchers studied the device in 171 patients who were taking part in a randomised drug trial and used computer software to calculate aortic blood pressure from the arm pulse pressure.

The study, published in the journal Hypertension, found it could give the ‘true’ central blood pressure and that it was higher at night than traditional arm measurements would indicate.

Lead author Professor Bryan Williams, from University College London, said: ‘What we have shown is that pressures by the heart do not dip as much during sleep as we previously thought. We know the pressure when someone is asleep is a strong predictor of heart disease. This [the device] almost certainly gives a better measure than blood pressure in the arm.

‘This is not mainstream, but in the future you could see people having their central blood pressure measured instead of in the arm.’

Elsewhere UK cardiologists are saying that current diagnostic tests on people with chest pain are inadequate, the Independent reports. The researchers believe angiograms should now be updated to include measurement of fractional flow reserve (FFR) to get a better idea of exactly which coronary arteries have reduced blood flow – something that does not always reflect the degree of blockage on the angiogram.

FFR involves using a pressure wire in conjunction with angiography to measure the blood pressure within individual arteries. In a study of 200 angina patients, the team found that over a quarter of patients would have received the wrong treatment based on their angiogram findings alone. In these cases, the cardiologists changed the management plan after seeing the additional FFR information. Furthermore, they changed their view on whether individual coronary arteries had ‘significant’ stenosis in almost a third of vessels.

‘Although this was a proof-of-concept study, the results indicate management of patients with stable angina by angiogram alone is probably flawed and treatment would be much more tailored to the individual through routine use of a FFR pressure test at the diagnostic stage,’ said lead researcher Professor Nick Curzen, from Southampton General Hospital.

Finally, the Telegraph reports on how a vaccine could potentially stop millions of exotic holidays being ruined every year. The vaccine – taken in the form of a pill – combats the E. coli that causes so-called Delhi belly, as well as the Salmonella strain that causes typhoid.

The vaccine includes a modified E. coli bacteria which is dried into powder form and bound up in a resin so that when ingested it is protected from bile acids and rehydrated and absorbed in the small intestine – where it ‘primes’ the immune system against infection at the site of usual infection.

Lead researcher Professor Nigel Slater, from the University of Cambridge, said: ‘As we are creating immunity at the site where an infection from enterotoxigenic E. coli would normally first occur – in the digestive system – it allows the immune system to be primed against it at the first line of defence.

‘This should make it more effective than traditional vaccines. We have had some promising results in trials in animals and we are now aiming to start clinical trials in humans later this year.’


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