Angina and coronary heart disease

Colourful imaging of a fatty plaque which has accumulated in an artery

Our research has helped to dramatically reduce the death rate from coronary heart disease, however it is still the biggest killer in the UK. 

Coronary heart disease, sometimes just called heart disease, is caused by a gradual build-up of fatty material leading to the narrowing of coronary arteries. Fatty build-up in the arteries is also known as atherosclerosis.

Angina is a symptom of coronary heart disease usually characterised by pain or discomfort in the chest.

When we were formed in 1961 the total number of deaths from coronary heart disease in the UK that year was more than 160,000. But thanks in-part to BHF-funded research this number has halved. In spite of this coronary heart disease is still the single biggest cause of death in the UK. 

Although the death rate from coronary heart disease has come down, the burden is still great. There are now approximately 2.3 million people living with coronary heart disease in the UK. 

Statins to lower cholesterol

In 1989, we helped to fund the first large trial that looked at whether statins could help to lower the risk of people with high cholesterol levels from developing coronary heart disease. People who took statins reduced their risk of having a first-time heart attack by nearly a third.

High blood cholesterol is a major risk factor for coronary heart disease, and the development of statins was a major step forward in prevention.

Developing a risk calculator

Retired BHF Professor Keith Fox led an international initiative to build up a large database of patients admitted to hospital with chest pain around the world, recording what their symptoms were, whether they’d had a large or small heart attack, what treatment they received, and what their outcomes were. He found that people who’d had a mini-heart attack had a poorer outcome because doctors didn't treat them with enough urgency. 

Professor Fox and colleagues then developed  a 'risk calculator', called the GRACE score, which doctors in hospital emergency departments can use to accurately assess patients with chest pain to decide what treatment they should receive. 

A patient's story

Elizabeth Scarr had already suffered one heart attack, and when she began to experience neck and shoulder pain some time later, was diagnosed with unstable angina and admitted to hospital. Her medical history became part of Professor Fox's research which has now improved diagnosis and treatment for heart disease sufferers all over the world.

The SPECT test

In 2012, BHF Senior Clinical Fellow Professor Sven Plein and Professor John Greenwood published the results of a BHF-funded study in the medical journal The Lancet demonstrating that MRI, when used in combination with other tests, is as accurate and reliable a method for detecting coronary heart disease as the standard SPECT test. This finding was important as SPECT exposes patients to radiation and MRI doesn't.

Ongoing research

We are now funding research at the University of Glasgow looking at the best way of diagnosing coronary heart disease in people with atypical angina who don’t have a blockage in their coronary arteries, but who may have problems with the small blood vessels supplying the heart. 

Professor Colin Berry and his team will insert a wire into the coronary artery to measure blood flow to smaller blood vessels to see how often people with angina have
problems in these tiny blood vessels, and if measuring blood flow in these vessels can help to diagnose people with atypical angina.

Studies have shown that angina can be triggered by physical activity or by mental stress. Dr Satpal Arri is being funded by the BHF to carry out research at King's College London investigating the effect of mental or emotional stress on people with angina. It's thought that the underlying mechanism behind the angina may differ depending on whether the stress is physical or emotional. 

Research like this will help us to understand the different causes of angina and may lead to more specific treatments for people like Al who suffer from angina. 

Support heart research

This research was only possible with your help, but there is still much more work to do. We need your donations to help us continue funding cutting-edge heart research.