Thursday 23 Oct 2014

Information and opinions presented here do not always represent the views of the American Heart Association.

AHA funding new research network aimed at preventing heart disease, stroke

Published: 12:52 pm CDT, June 27, 2014

Four major institutions are banding together and leveraging the strength of basic, clinical and population research to prevent heart disease and stroke, the two leading causes of death in the world.

The Strategically Focused Prevention Research Network Centers — funded by a $15 million grant from the American Heart Association — will collaborate on research in such areas as obesity, high blood pressure and heart failure.

The network will be made up of investigators at Northwestern University in Chicago, Vanderbilt University in Nashville, the Icahn School of Medicine at Mount Sinai in New York City and the University of Texas-Southwestern Medical Center in Dallas.

Funding begins July 1.

“Heart attack and stroke can strike suddenly, and frequently without warning. The best way to reduce premature mortality from cardiovascular diseases and stroke is to prevent the development of the risk factors that lead to these conditions,” said AHA President Elliott Antman, M.D., professor of medicine at Harvard Medical School and a senior physician in the cardiovascular division of the Brigham and Women’s Hospital in Boston. “Scientists working in these research centers are helping to discover the mechanisms that will allow all Americans to live healthier lives, helping lead us to a culture of health.”

A culture of health is an environment where the default choices people make are the healthy ones. For example, the air is smoke-free, nutritious foods are easy to find, safe places to exercise are abundant and quality healthcare is accessible.

The culture of health concept is also important to the association’s goal to improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent by 2020.

Northwestern University will take a closer look at why heart-health measures decline from childhood to middle age and see if the latest techniques can help maintain ideal heart health and reverse declines. The goal is to learn how to implement behavior change programs on a large scale to benefit as many people as possible.

“The expectation to exchange ideas among researchers working from different perspectives on a shared theme is exhilarating,” said Philip Greenland, M.D., the school’s Harry W. Dingman professor in the departments of Preventive Medicine and Medicine, Feinberg School of Medicine. “We expect that this work will extend prevention research widely throughout our institution and even more broadly.”

The center’s steering committee chair, Donald Lloyd-Jones, M.D., ScM, Northwestern’s senior associate dean for clinical and translational research and chair of the Department of Preventive Medicine, said preserving and promoting cardiovascular health across the lifespan has been a departmental focus for 15 years.

“We are excited to leverage this partnership with the American Heart Association and the other centers to bridge critical gaps in our knowledge about the life course of cardiovascular health, and to improve the cardiovascular health of all Americans,” he said.

Two major hurdles — an overly salty, heart-hurting diet and the frequent need to take multiple, expensive medications — is spurring Vanderbilt University to develop new approaches for preventing high blood pressure.

The goals are to understand how salt causes tissue injury, develop a method to detect and lower excess salt, and determine if a simple treatment in one pill can improve cardiovascular health.

That’s an “enormous opportunity,” said Vanderbilt’s David G. Harrison, M.D., the Betty and Jack Bailey Professor of Medicine, pharmacology and physiology director of Clinical Pharmacology.

“Our center will focus on preventing hypertension, which is an enormous risk factor for heart disease, stroke and kidney disease. We are beginning to understand how common risk factors like diet and lifestyle predispose to hypertension, and taking measures to correct these,” Harrison said.

Nearly one-third of adults and children in the United States are obese, with rates even higher in Hispanic and African-American communities.

The Icahn School of Medicine at Mt. Sinai will aim to build a culture of health in Harlem, New York City, with an urban-based health program targeting kids who are as young as 3 as well as their caregivers.

Obesity is closely linked to heart disease, stroke, Type 2 diabetes and certain types of cancer, among the leading causes of preventable death.

The focus will be a family-centric approach to preventing heart disease in New York City’s highest-risk communities, said Valentin Fuster, M.D., Ph.D., director of Mount Sinai Heart, physician-in-chief of The Mount Sinai Hospital, and chief of the Division of Cardiology at Icahn School of Medicine at Mount Sinai.

“Prevention through the promotion of cardiovascular health is the most powerful tool we have in our arsenal in the fight against the global epidemic and devastating toll of cardiovascular diseases,” Fuster said. “We look forward to gaining a better understanding of how a child’s behavior, environment and genetics intersect, leading to the development of heart disease, while also learning how best to refine our prevention techniques to better protect and preserve our children’s future heart health.”

Heart failure, when the heart can’t pump enough blood to the organs, is one of the most common reasons people 65 and older go into the hospital. There are no proven therapies to prevent heart failure with preserved ejection fraction (hFpEF — when the heart contracts normally but the ventricles, the heart’s two lower chambers, don’t relax or are stiff so less blood enters). Relative to other forms of heart failure, hFpEF occurs in about half of heart failure patients and patient prognosis has remained relatively unchanged over the past two decades, so the University of Texas-Southwestern Medical Center wants to shift the focus to prevention.

“We argued that hFpEF is the single largest unmet need in cardiovascular medicine,” said Joseph A. Hill, M.D., Ph.D., professor of medicine and molecular biology and the chief of cardiology at UT Southwestern Medical Center. “This is an exciting opportunity to tackle the central core of heart disease — that is trying to prevent before it emerges.”

He points to dramatic successes in decreasing heart disease over the last 50 years — thanks to research funded by the AHA, the National Institutes of Health and others. But heart disease is still the No. 1 killer in the Western world, due in part to the worsening obesity epidemic and longer life spans.

Each network center will receive about $3.8 million during the next four years.