Q: What are the challenges in cardiovascular research that you feel the American Heart Association can help address?
While the American Heart Association funds research in all the basic, clinical, and population fields relevant to the broad spectrum of cardiovascular diseases and stroke, I'd like to highlight two particular challenges. One of the primary challenges that we're addressing is the need for healthier lifestyles as a means to preventing cardiovascular diseases and stroke. One in three American adults has some form of cardiovascular disease, yet in up to 80 percent of cases, these illnesses can be prevented by making sensible everyday decisions, like engaging in regular exercise; limiting our intake of sodium, added sugars, and saturated and trans fats; and taking prescribed medications. Today, too many people are overlooking the importance of healthy lifestyles and their long-term health benefits; only one in five get recommended levels of physical activity, two out of three are overweight or obese, and one-third have hypertension. One of the primary objectives of the American Heart Association is to instill a culture of health, in which people embrace the value of prevention and its long-term benefits. This needs to include the critical area of behavioral science. More and more research studies are being published about how people's environments and cultural influences affect the lifestyle decisions they make, and how changes to these environments – such as greater availability of playgrounds and other recreational facilities in urban areas, or making fresh fruits and vegetables more accessible and affordable – lead to healthier decisions.
Another critical and major investment for the American Heart Association lies in research connecting increasingly sophisticated genomic information with deeper and more extended phenotyping in individuals and groups. Novel computational and analytic techniques will help this "big data" resource more rapidly lead the way to more personalized and precise medicine.
Q: The association funds both investigator-initiated and strategically focused research projects. Why are those both important means to help overcome the barriers you've identified?
Investigator-initiated, basic research is and always has been the primary focus of our research program, and that's because when you fund bright, creative minds and give them the flexibility to pursue their ideas, great discoveries ensue. That has been our experience since we began funding research in 1949, and the knowledge gained from basic research has contributed to the development of the first artificial heart valve, the techniques of CPR, microsurgery, cholesterol-inhibiting drugs, drug-eluting stents, and the first implantable pacemaker.
Recently we initiated a new item in our research portfolio to allow strategically focused investigations, because there are several key areas that we believe can accelerate the achievement of our national health impact goal, reducing cardiovascular disease and stroke mortality by 20 percent, and also improving overall cardiovascular health by 20 percent by 2020. Beginning next year, we will fund two Strategically Focused Research Networks each year. Each network will be comprised of three to four institutions with three projects each, as well as new collaborative projects, all focused on one area strategic to our mission of building healthier lives, free of cardiovascular diseases and stroke. Our first strategically focused network, launching this year, is in prevention.
Q: The association recently created a Science and Technology Accelerator Program. Tell us a bit about that effort and why you launched it.
We launched the Science and Technology Accelerator in 2012 to identify potentially game-changing innovations in cardiovascular medicine and propel them rapidly from bench to bedside, where they can dramatically impact outcomes. Because of the current scarcity of funding, many scientific innovations lack the capital necessary to demonstrate proof of concept required to attract private equity or industry funding. The "Valley of Death" between basic science grants and private support for commercialization results in many potentially transformational technologies languishing, and ultimately dying. We have a team of world-renowned volunteer experts in a range of fields, such as clinical development, regulatory affairs, intellectual property, and commercialization who are deeply committed to this program. The accelerator depends entirely on direct donations; none of the dollars from our research program are used. Thus far we have funded two projects. The first is in CytoVas, which has developed a "Vascular Health Profile" blood test aimed at identifying seemingly healthy people who are actually at risk for heart attack or stroke. Our investment in the conduct of CytoVas' proof of concept (POC) trial was perceived to have de-risked the technology sufficiently such that a major industry investor formed a partnership with them even before the first patient was enrolled in the POC trial.
Our second and more recent investment, along with Broadview Ventures and North Carolina Biotech, is in BioKier, which promises a revolutionary treatment to type 2 diabetes patients. This innovation involves unmodified substances present in the diet, and FDA-approved as "generally recognized as safe" (GRAS), which are delivered orally and pass through the stomach, undigested, to bind with receptors, which can result in dramatic increase in insulin production and apparent decrease in insulin resistance. Usually, these substances would pass through the system with no effect, but the delivery system created by this joint venture can potentially have an important beneficial effect on type 2 diabetes, a major risk factor for cardiovascular disease and stroke.
Q: What do you consider the association's greatest accomplishments over the last decade?
Perhaps the most important accomplishment over the past decade is improving the quality of patient care in hospitals. Since we launched these initiatives just over a decade ago, more than 6 million patients have been enrolled in our programs like Get With The Guidelines, which provide evidenced-based protocols for treating conditions including stroke, heart failure, heart attack, sudden cardiac arrest, and atrial fibrillation. Also, more than 250 articles have been published in the scientific literature about these effective quality-of-care efforts, felt to be responsible for about 50 percent of the reduction in cardiovascular disease and stroke mortality over the past decade. These programs can also reduce and even eliminate health disparities in care.
In addition, in women's heart health last month we celebrated the 10th anniversary of Go Red For Women, our movement to raise awareness of heart disease in women. We've nearly doubled the percentage of women who know heart disease is their No. 1 cause of death, from 30 percent to 57 percent, and we've engaged nearly 1.9 million women in the movement, 90 percent of whom have gone on to make at least one healthy lifestyle change since joining.
I'm also very proud of our further progress in reaching multicultural audiences, through programs like Power To End Stroke, which was launched in 2007 to raise stroke awareness among African-Americans, who are at particularly high risk, and Go Red Por Tu Corazón, which brings all of Go Red For Women's resources to Spanish-language audiences, and which also funds an annual scholarship program to support women who want to pursue careers in healthcare.
Q: What are your top research goals over the next year, and what will it take to reach those goals?
We enter each year with the goal of funding as many new research awards as possible, crossing an ever-increasing range of disciplines. Last year we spent $136 million to support 978 research awards, the fourth consecutive year that we've been able to increase funding compared to the previous year since the economic downturn. All of our research decisions and goals are based on selecting the very best and most impactful science.
We're very excited about two new research partnerships that get underway this year. One is the American Stroke Association-Bugher Foundation Centers of Excellence in Stroke Collaborative Research for Regeneration, Resilience and Secondary Prevention. This is made possible by a $9.6 million grant from the Henrietta B. and Frederick H. Bugher Foundation, which has provided more than $35 million on our behalf since 1984.
Also this year, we're embarking on an unprecedented initiative with Boston University and the University of Mississippi, called the Cardiovascular Genome-Phenome Study. This will build on the databases of the landmark Framingham and Jackson Heart Studies, adding more research subjects, new cohorts, more genetic analysis, and deeper new approaches to gathering information in an effort to find more "personalized" treatment and prevention of cardiovascular disease.
For more information about the American Heart Association: