Dr Vikas Kapil

Profile

ORCID iD: 0000-0001-5778-6188

Vikas Kapil read Medicine and Anatomy at Queen’s College Cambridge, achieving first class undergraduate honours and then transferred for his undergraduate clinical training to University College London Medical School.

He completed postgraduate training at St Thomas’ and St Bartholomew’s hospitals and was awarded his PhD under the supervision of Professor Amrita Ahluwalia at the William Harvey Research Institute, investigating the effects of inorganic nitrate on the human cardiovascular system.

Since 2015, he has been a senior lecturer at WHRI and consultant in the Barts BP Centre of Excellence at Barts Heart Centre. He is heavily involved in leading therapeutics and prescribing training for the MB BS (Medicine) course and also leads a module for the final year BSc Biomedical Sciences degree course.

Research

Group members - Pharmacology & Therapeutics 

Members of Vascular Pharmacology Group: Prof Amrita Ahluwalia (Head), Dr Vikas Kapil (Senior Lecturer), Dan Jones (Senior Lecturer), Dr Ray Khambata (Senior post-doctoral researcher), Dr Sven van Eijl (Lab manager)

PhD Students: Dr Krishnaraj Rathod, Dr Clement Lau, Dr Chris Primus, Sascha Hamers, Federica Filomena, Lorna Gee

Members of Blood Pressure Group: Dr Mel Lobo, Dr Ajay Gupta, Mr Sotiris Antoniou, Dr David Collier, Dr Peter Julu, Dr Chris Wolff

Summary 

Inorganic Nitrate in Cardiovascular Disease
A major research focus of the Vascular Pharmacology group at WHRI, led by Prof Amrita Ahluwalia, is the study of the bioactivity of the reductive nitrate-to nitrite to NO pathway in humans, often dubbed the enterosalivary circuit of inorganic nitrate.  

Made the first demonstrations of the protective effects of inorganic nitrite against myocardial ischemia-reperfusion injury implicating two enzymes in the conversion of nitrite to NO: xanthine oxidoreductase and eNOS.

More recently, the vasodilator activity of nitrite has attracted much attention. In 2008, published the first findings that a dietary nitrate load, in the form of beetroot juice, reduces blood pressure and improves platelet and endothelial function in healthy volunteers. Similar results have been confirmed in longer term studies in patients with hypertension and hypercholesterolaemia.

Ongoing research focuses on: 

• discovery of new druggable targets in the renal system involved in pharmacokinetic handling of nitrate and nitrite
• the effect of inorganic nitrate to hypertensive target organ damage, including adverse cardiac and vascular remodelinte contribution of the oral microbiome to, and sex differences in, the entero-salivary circulation
• the contribution of the oral microbiome to, and sex differences in, the entero-salivary circulation

Refractory Hypertension and Blood Pressure Disorders
A multi-disciplinary group of internationally-accredited BP and hypertension physicians, cardio-respiratory physiologists, autonomic neurophysiologist, and pharmacist investigating and developing novel strategies to treat complex circulatory problems.

• Multiple-drug intolerance in hypertension

Defined a new syndrome of multi-drug intolerant hypertension to describe the 10% of patients referred to Barts BP Centre of Excellence who are unable to take guideline-based treatment for hypertension due to both pharmacologically expected and unexpected adverse effects. Published the first evidence in this difficult to treat group having developed a unique, pragmatic approach using a 4-step algorithm based on parallel evidences about dose-dependency of treatment and adverse effects; excipients causing adverse effects; and using off-label use of licensed medications for their anti-hypertensive effect.

• Autonomic and haemodynamic profiling in circulatory disorders

Using a suite of non-invasive autonomic function tests and state-of-art haemodynamic technologies to get insights into regional sympathetic and cardiac parasympathetic function, and vascular regulation in patients with various circulatory disorders, including idiopathic highly variable blood pressure, postural orthostatic tachycardia syndrome (POTS) and refractory hypertension to determine targeted non-pharmacological and pharmacological approaches to symptomatically improve this diverse population.

• Device based treatment of hypertension

Leading, with Dr Mel Lobo (Director, Barts BP Centre of Excellence) the first UK experience of baroreflex stimulation (Barostim Neo, CVRx) for refractory hypertension and first-in-man use worldwide for symptomatic, highly-variable blood pressure.

Involved in sponsor-led trials of device based treatments of hypertension, including renal denervation (radio-frequency, ultrasound etc.), baroreflex amplification (Mobius HD device), central arterio-venous anastomosis creation (ROX fistula) and applying autonomic profiling to understand pathophysiology

Awards

Collaborators

• Dr Mike Barnes (WHRI)
• Prof William Wade (Blizard)
• Dr Ben Walsh (UCL)
• Dr Iasonas Triantis (City University)
• Prof Julian Paton (Auckland)
• Dr Emma Hart (Bristol)