Atlantia Clinical Trials interviews Professor Eric de Groot, PhD about the state of Cardiovascular Research.
Has there been an increased prevalence of cardiovascular disease (CVD) in recent times?
We have already entered an era with an increasing number of elderly in the population. This is both for demographic reasons as well as longevity. As a consequence vascular-related diseases become increasingly apparent making prevention of disease more important than ever. We also need to realize vascular diseases not just include coronary heart diseases, but also entail a wide variety of disabling conditions like stroke, Alzheimer’s disease, and the consequences of metabolic syndrome and diabetes. Common causes of early undesirable vascular harm leading to CVD are smoking, alcohol use, obesity, and sedentary occupations. At any age and preferably built-in one’s daily routines, health and wellbeing always benefit from a healthy diet and a physically active lifestyle.
Have there been advancements made in the techniques used to diagnose heart disease and what are they?
As the topics are strongly interconnected, I would like to take your question on diagnosis a bit further and extend it to prevention and treatment as well. From a scientific perspective, the understanding of the mechanisms underlying heart and other vascular diseases, and their therapeutic consequences, have greatly advanced over the last decades. This is an ongoing multidisciplinary undertaking that includes insight into pathophysiology, epidemiology, and genetics. The identification and the ability to modify risk factors by efficacious lifestyle, nutraceutical and pharmaceutical means has created opportunities for focused preventive measures and symptomatic treatment. On the clinical side, better public awareness to recognize a vascular accident, diagnostic means, and treatment of symptomatic patients in specialized units has considerably increased survival rate of those ridden with coronary heart disease and stroke. On the prevention side, laboratory parameters and genetics have become increasingly important in the early diagnosis of vascular disease risk. Advanced multi-arterial blood pressure measurements and non-invasive imaging technologies like vascular ultrasound, MRI and coronary CT scans have improved individual risk scores. These technologies have become more available and hence applicability for preventive purposes and personalized treatment have improved.
Have there been any new factors that increase the risk of CVD identified?
There is increasing evidence chronic inflammatory conditions of organs outside the arterial tree can greatly influence cardiovascular health. As an example, inflammatory bowel diseases like ulcerative colitis and Crohn’s disease considerably increase the progression of atherosclerosis. Metabolic syndrome and overweight also cause a chronic inflammatory status increasing CVD risk. Also, great effort is put into the diagnosis of bowel microbiome composition, amongst others by ‘sniffing’ volatile organic compounds in the expiratory air and inducing inhibition of inflammatory processes by favorably altering the microbiome by pre- and probiotic and dietary treatments.
How has the view on nutrition changed for the prevention of CVD?
A long line of solid scientific knowledge now supports the effects of nutrition on cardiovascular health. This is a good development and runs parallel with the notion of the scientific and medical community that the incidence of CVD can be decreased by early identification of risk and early preventive measures. In other words, medical professionals were very much inclined to focus on treatment of symptomatic disease. Now there is an increasing awareness by care givers implementation of preventive measures can play active roles in primary and secondary CVD prevention. Strictly speaking I would be in favor of considerable more attention to nutrition and physical education in school ages.
Key nutritional opportunities to help prevent cardiovascular disease/or improve & maintain heart health (e.g. functional foods etc.)
An example of a nutritional opportunity is our recent study in a type of sugar with a longer half life that creates a more favorable vascular function profile and may benefit those with obesity and early diabetes. The favorable effects of unsaturated fats are well known. Although the acceptance of a healthy lifestyle to promote wellbeing and prevent diseases is supported and guided by science, to make things work there must be continuous effort to create awareness of the need of that healthy diet with consumers, producers and regulatory bodies alike.
Do you think digital health has a role to play in awareness, prevention and management of CVD?
The opportunities to monitor and provide feedback on one’s health by digital and wearable technologies are endless. It is a most exciting field. Although the physics of the devices and physiology of the human body have been known for a long time, the coming of age of smart technologies provides real-time synchronous and complementary information on incoming medical data and – for example - location and time. Smartphone app’s now can seamlessly integrate blood pressure, heart rate variability and other bodily functions as well. As feedback in the digital health environment can be immediate, it is a most useful tool in personal training and in the understanding of medical conditions and their follow-up. In line with the two previous questions, it is critical to pay continuous attention to the human factor. Hence, as a health professional, one must take the time and effort to put the data in the right perspective to reach a personalized feedback and advice.
Are there opportunities for further research in the area of CVD and heart health?
Science is about understanding and research is its tool to provide valid quality-assured data. Human cardiovascular studies using validated biomarker data can identify health status, disease risk and efficacy of intervention even prior to the occurrence of disease. This research is therefore essential to prove product need and its efficacy. Fueled by regulatory requirements, consumer and industry needs, I think the landscape of nutrition research and improving heart health by efficacious diets has changed for the good. As the worldwide need of preventive health diets increases and product health claims require to be solidly supported by human studies, I think this positive trend to intensify nutrition research in de cardiovascular field will continue. As health needs are pursued, I see this trend as being mutually beneficial for producers and the well-being of customers.
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