Peter Sleight, MD FACC

Professor Peter Sleight is currently Honorary Consultant Physician at the Oxford Radcliffe NHS Trust (since 1964), Emeritus Professor of Cardiovascular Medicine University of Oxford, and Emeritus Fellow Exeter College, Oxford.

Professor Sleight was formerly President of the World Hypertension League and serves as chair of the ISIS group steering committee and the related coronary prevention studies coordinated by the Clinical Trials Service Unit in Oxford.

He retired from the BHF-sponsored Oxford University Field Marshal Alexander Chair of Cardiovascular Medicine in 1994.

He is the recipient of awards, including the

• American College of Cardiology (ACC) Young Investigator’s Award, 1963
• Evian Award for Medicine and Science
• International Society of Hypertension - MSD Award for Distinguished Research
• Society of Apothecaries’ Galen Medal for Therapeutics, 2000
• Mackenzie Medal, British Cardiac Society, 2003
• Louis Bishop Lecturer American College of Cardiology, 2004
• Alberto Zanchetti Lifetime Achievement Award, European Society of Hypertension
• Lifetime Research Award, Russian Federation of Cardiology 2005.

He was nominated as the Maseri-Florio lecturer at ACC 2008.

Professor Sleight is a Fellow of the American College of Cardiology and has served on the editorial board for many cardiology journals, including: Cardiovascular Research, Cardiovascular Risk, Circulation, Hypertension, the British Heart Journal, Clinical & Experimental Physiology & Pharmacology, and the Journal of Ambulatory Monitoring. He has published over 400 original scientific papers in such journals as The Lancet, New England Journal of Medicine, Circulation, Heart, European Heart Journal, the British Medical Journal and Clinical Science on a wide variety of topics, including:

• – blood pressure monitoring and control
• – autonomic control of the circulation
• – prognostic value of measures of heart rate variability
• – pathophysiology of ischaemic heart disease
• – heart failure
• – hypertension
• – and the autonomic effects of music.

Professor Sleight remains an active contributor to the field of cardiology. As chair of the ISIS group steering committee he has been involved in international trials in cardiology, such as the use of Aspirin (ISIS-2), Thrombolysis (ISIS 2&3), ACE Inhibitors (HOPE) and Statins (HPS). He has served or continues to serve on several data monitoring committees of major clinical trials, including Gusto, ECLA, CREATE, OASIS 5-7, COMMIT, VALUE, PACE, SCOUT, ORIGIN, GISSI-HF, RELY, CURRENT,and PrOFESS.

Music, Mantras, Prayer & Biological Rhythms

Monday, March 17, 2008
7:30 AM

Download Dr. Sleight’s slide set [723.63 KB PDF].

Physiological rhythms are central to life. We are all familiar with the beating of our heart, the rhythmic motions of our limbs as we walk, our daily cycle of waking and sleeping.

Other rhythms, equally important but less obvious, underlie rhythmic changes in blood pressure (the Mayer waves), the release of hormones regulating growth and metabolism, the digestion of food, and many other bodily processes. These rhythms interact with each other, as well as with the environment, under the control of innumerable feedback and feed forward systems that provide an orderly function that enables and regulates vital processes. Disease is often associated with the disruption of these rhythmic processes.

Diseases that impair cardiac function – for example, heart failure, hypertension, and diabetes – reduce heart rate variability, which is a powerful adverse factor.

Although many cells and structures in the body can display intrinsic spontaneous rhythmicity, physiological function derives from their interactions, for example, locomotion and breathing rate. Physiological oscillations are often entrained by appropriate external or internal stimuli; therefore, it is important to analyze the effects of these stimuli on intrinsic physiological rhythms.

In this review, we examine some of the most relevant examples of interaction between biological rhythms and music, prayer & mantras, their possible practical outcomes, and the potential place of music therapy for cardiovascular health.

Why Do We Need Clinical Trials?

Wednesday, March 19 2008
8:00 AM

Download Dr. Sleight’s slide set [610.11 KB PDF].

Randomized clinical trials (RCTs) are definitive contributors to evidence-based medicine. RCTs assessing serious outcomes in cardiovascular disease have grown and been followed by many cardiology collaborations, with ‘megatrials’ becoming more common due to the realisation that wrong conclusions resulted from random error in inadequately sized trials.

Simple design and heterogeneous patient populations were early features but multinational trials increased the scientific, logistical, bureaucratic, regulatory, and legal complexity. Perhaps the greatest contribution of large randomised trials is to demonstrate the safety (or harm) from any new therapy.

These studies now exceed the financial means of academia or medical charities. Governments have left the bill with the pharmaceutical industry, encouraging a symbiosis with academics who contribute medical and scientific expertise and access to patients. Industry provides pharmacological, pharmaceutical, technical and regulatory know-how, good clinical practice expertise and legal assistance during the trial. Study supervision is then in the hands of an independent steering committee and associated subcommittees until appropriate dissemination of results.

Prospectively-defined interaction with the sponsor facilitates unbiased trial design and conduct, but these arrangements need careful implementation to avoid conflicts of interest. The patient is protected by a strong data monitoring board – which is wholly independent.

We have been conducting the largest comparison so far of an ACE inhibitor (ramipril) versus an ARB (telmisartan) versus the combination – the ONTARGET study, which will be reported at the ACC 2008. (See also recent meta-analysis by Matchar et al, Ann Int Med 2008;148:16-29, which showed no outcome differences between ACEIs & ARBs, but greater compliance with ARBs).

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