The BHF’s research highlights of 2019 – British Heart Foundation

From an algae-based treatment for preventing limb amputation, to highlighting the stark gender inequalities in heart attack treatments, the BHF has been funding life-saving research into heart and circulatory diseases throughout 2019. This is all thanks to the generous support of the public - we take a look back on the BHFs research highlights of 2019.

In January, we launched the Big Beat Challenge, one of the largest research grants of its kind in history. This is a single funding award of up to 30 million aiming to encourage international, multi-disciplinary teams to identify a key problem in any heart or circulatory disease and propose a transformational solution.

Our advisory panels, including international scientific experts and members of the public, have been hard at work assessing applications. Keep an eye out for the shortlist of the most exciting projects, which will be announced in early 2020.

Statins are drugs commonly prescribed for lowering cholesterol. Cholesterol is a fatty substance in the blood, produced naturally in the liver. There are two types: good cholesterol (HDL) and bad cholesterol (non-HDL). We all need some cholesterol for our bodies to work effectively, but if you have too much bad cholesterol, it can clog up your arteries and increase the risk of heart attack or stroke.

In February, a study part-funded by us showed that statins lower the risk of heart attack and stroke in all ages by lowering cholesterol levels. Previously, there had been concerns that statins were not so beneficial for those over 75. However, this review of 28 major clinical trials found that statin treatment for the over 75s reduced their risk of a heart attack or stroke by 20 per cent for every millimole per litre reduction in bad cholesterol. This shows that age should not prevent people being prescribed statins.

Smartphones have the potential to transform the diagnosis of certain conditions. Research part-funded by us showed that a smart-phone based ECG recorder could be used in A&E to help diagnose heart rhythm problems. The study included people visiting Emergency Departments after experiencing palpitations (where heartbeats are suddenly more noticeable) or pre-syncope (feeling faint or as if you are going to black out).

Most of the time palpitations are harmless and are caused by factors like caffeine or stress. However, they can be a sign of a serious heart rhythm problem called atrial fibrillation, which can lead to a stroke, so its very important to accurately diagnose the cause. The problem is that by the time someone has an electrocardiogram (ECG) in hospital to detect their heart rhythm, their heart beat may have returned to normal, so the underlying problem cant be diagnosed.

The researchers gave the smartphone-based device to people who came to hospital having experienced palpitations or pre-syncope. The device could be taken home and stuck to the back of a smart phone, for the individual to use if they experienced the same symptoms again. The resulting ECG could then be sent to a doctor to help diagnose the problem. The researchers found that the smartphone device was five times more effective at diagnosing heart rhythm problems than standard tests. Whats more, the device also cut the cost of a diagnosis by an average of 921, from 1395 to 474.

More commonly associated with garden ponds, algae could reduce the need for amputation in people with critical limb ischaemia (CLI). CLI is a severe form of peripheral artery disease, where the blood vessels in the legs and feet become blocked. In some cases, this can eventually result in limb amputation.

Professor Bijan Modarais team developed a way to place macrophages, a type of white blood cell, inside small capsules made from brown algae. Delivering these capsules into the injured limbs of mice helped the cells to stay within the area, where they could drive an increase in blood flow. The team now hope to carry out this research in humans, in the hope that this treatment could reduce the number of people who need an amputation due to CLI.

Before you get too excited, no, this research does not give you licence to drink limitless quantities of red wine in the name of healthy blood pressure. The health risks of drinking alcohol clearly outweigh any benefits of the components of red wine, which may be used separately to develop new treatments.

BHF-funded researchers at Kings College London have found that a molecule called resveratrol, which is found in the skin of red grapes, can lower blood pressure in mice. They gave mice with induced high blood pressure a diet including resveratrol for 15 days and found that their blood pressure dropped by around 20mmHg compared to mice fed a normal diet. This is because resveratrol affects a protein called PKG1alpha, which causes the blood vessels to relax and blood pressure to drop.

To consume the doses of resveratrol given to the mice in this study, you would need to drink 1,000 bottles of red wine a day, which is certainly not recommended. But the potential for researchers to use this molecule to develop a new blood pressure medicine is significant, as high blood pressure is an extremely common risk factor for heart and circulatory diseases - nearly three in ten adults in the UK have it.

The coming of June meant it was time for the British Cardiovascular Society (BCS) annual conference in Manchester. Several research projects which were funded by us were presented.

One of these, led by Professor Steffen Petersen, suggested that coffee is not as bad for our heart and circulatory system as previously thought. Previous studies had argued that drinking coffee led to stiffened arteries, which can increase the workload on the heart and so increase your chance of having a stroke or heart attack. This larger study of over 8,000 people found that drinking coffee was not actually associated with having stiffened arteries, even in people who drink up to 25 cups a day. While we definitely wouldnt recommend such a caffeine binge, it does seem that the effect of coffee on your arteries is not as bad as we previously thought.

Also presented was a study which could pave the way for heart patches being trialled in people. The team, led by Professor Sian Harding at Imperial College London, have developed a way to grow thumb-size patches of heart tissue containing up to 50 million human stem cells. These are programmed to turn into working heart muscle that can be seen beating. With further research, these patches could be potentially used in the future to help limit, or even reverse, the loss of the hearts pumping ability after a heart attack.

Heart failure is a debilitating condition which can make simple tasks like climbing the stairs or making a cup of tea feel like a real challenge. It means that your heart is not pumping blood around your body as effectively as it should. We urgently need new and improved ways to improve the quality of life for heart failure patients.

In July, we awarded funding to a team at University College London to test whether a drug which targets a molecule called gasdermin D could help limit the damage to the heart caused by a heart attack. We also made an award to a team at Kings College London, to look at whether another molecule called TAK1 could also play a role in the development of heart failure after a heart attack. While any findings from these studies may still be a way away from helping patients, we could not develop new treatments without advancing our understanding of molecular mechanisms of heart damage.

Our annual Reflections of Research competition brings together art and science, highlighting cutting-edge research into heart and circulatory diseases through eye-catching images. This years winner was Iona Cuthbertson, a PhD student at the University of Cambridge, who is looking at how certain types of smooth muscle cell in artery walls grow after injury. Ionas image, A Sea of Cells seems at first glance to be painted with thick brushstrokes. It is actually a close-up image of smooth muscle cells which surround blood vessels, with different molecules within them highlighted with fluorescent markers.

In the UK there are almost 4 million people diagnosed with diabetes. Thats nearly four times the population of Birmingham. Adults living with diabetes are at increased risk of developing heart and circulatory diseases and are nearly twice as likely to die from stroke or heart disease. This is because diabetes can cause damage to your blood vessels.

Research we funded showed that diabetes also causes subtle structural changes to your heart. Led by researchers at Queen Mary University, the team looked at the scans of almost 4,000 hearts, comparing the hearts of people with and without diabetes. They found that the volume of all four chambers of the heart was smaller in people with diabetes by roughly a teaspoon, a change that could be detected before more serious heart muscle damage occurs. In the future, this research could help detect heart damage in people with diabetes earlier, so they can get the required medical treatment.

What do you think of when you hear heart attack? The chances are that the first image that pops into your head is a man, perhaps elderly. It may be less likely that you would think of someone like Esther, who had a heart attack aged 45.

Many people still think of heart attack as a male problem, a misconception we challenged with the publication of our briefing Bias and Biology this autumn. Research funded by the BHF and others has uncovered that at every stage - diagnosis, treatment and aftercare - women who have heart attacks may receive poorer care than men. In fact, UK research has suggested that a woman is 50 per cent more likely than a man to receive the wrong initial diagnosis for a heart attack, and we know that delayed diagnosis is associated with a poorer outlook.

As well as raising awareness of the gender inequalities which exist, as of the end of 2019, we are currently funding 9 million worth of research into heart and circulatory diseases which affect women. For example, a team in Nottingham is looking into whether taking salt supplements during pregnancy could reduce someones risk of developing pre eclampsia, a condition which is potentially life-threatening to mums and babies. Hopefully this combination of research and challenging misconceptions will start to tackle the complex causes of the inequalities in heart health.

How safe is vaping? Well, a new study weve funded found that when heavy smokers switch to e-cigarettes, their blood vessel health improves within one month. If these improvements were sustained, risk of having a heart attack or stroke could be cut by at least 13 per cent by swapping from smoking to vaping. The VESUVIUS study, which is thought to be the largest of its kind, found it made no difference whether you swap to an e-cigarette with or without nicotine.

That isnt to say that e-cigarettes are safe, just that they are less harmful than traditional cigarettes for your heart and circulatory system. In practice, this means that you shouldnt start using e-cigarettes if youve never smoked before, but it may be beneficial for smokers to switch to them as a step to quitting smoking.

Continuing with the cigarette theme, in December we warned that the increased risk of death associated with living in areas of high pollution is equivalent to smoking 150 cigarettes a year. The most dangerous kind of air pollution is a fine particulate matter called PM2.5. Our research has shown that PM2.5 can have a seriously damaging effect on heart health, increasing your risk of heart attack and stroke. The UK council area with the highest annual average PM2.5 is Newham in East London, with an increased risk of death equivalent to smoking 159 cigarettes a year.

But its not all bad news. Recently published research showed how reducing air pollution can have a dramatic benefit on health in a short space of time. This is evidence that decisive national and local policies to tackle air pollution can lead to health improvements. The BHF is calling on the government in 2020 to make such decisive policies by adopting into law tougher World Health Organisation (WHO) air pollution limits.

None of this research could be possible without your help. With your continued support, we will be able to fund even more cutting-edge research into the worlds biggest killers throughout 2020.

Ever wondered which animal has the most complex heart? Or how what you drink can affect your health? How about if you can die from a broken heart?

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