Barbara Casadei: world-class research into atrial fibrillation

Barbara Casadei

Professor Barbara Casadei caught the science bug at school, and now she’s inspiring the next generation. She tells Madeleine Bailey about her BHF honour and her exciting research into atrial fibrillation.

Barbara Casadei doesn’t exactly fit the traditional stereotype of a science professor. A mere one in five UK professors is female, according to the Higher Education Statistics Agency – and, in science, the figures are lower still, at one in ten. This, she emphasises, is down to social conditioning and not ability.

“There’s no question that women can do science as well as men,” she says. “But there’s a lot of subtle messaging that implies science is for boys and the arts are for girls. As a result, girls aren’t encouraged in the same way.” Not that this deterred the young Barbara. “I loved the precision of science, where something was either right or wrong – or so I thought – but it probably also helped that my mum is a forceful character and never let me doubt that I could do well,” she explains.

"There’s no question that women can do science as well as men"

This is something of an understatement. A glance at Professor Casadei’s CV – all 14 pages of it – is enough to give most of us an inferiority complex. Besides the title of BHF Chair – given to ‘individuals with outstanding cardiovascular research leadership qualities’ – her achievements include nine awards and distinctions, starting in 1978 with an academic scholarship to study medicine at the Collegio Nuovo of the University of Pavia, Italy.

Now Professor of Cardiovascular Medicine at the University of Oxford, where she’s been since her arrival in the UK in 1989, she divides her time between research, running the John Radcliffe Hospital’s Hypertension Service, which looks after patients with hard-to-treat high blood pressure, and teaching.

Barbara Casadei in the lab“I love the mix,” she enthuses. “Multitasking helps me to keep a balanced view of the issues. If you just work in the lab, it’s easy to get lost in detail and do research for its own sake, but working with patients means you keep the ultimate aim in mind. The teaching is also great for keeping you on your toes – the students are amazing.”

Initially, Barbara only intended to come to the UK for three months but, nearly 24 years later, she’s still here. “My mentor, who had worked in the UK, inspired me to come over for a short time,” she remembers. “But after six months, I loved it so much that I resigned from my permanent position in Italy for one here that wasn’t secure.”

It was a risk that’s certainly paid off. Within two years, she’d been awarded the Joan and Richard Doll Research Fellowship at Green College, Oxford, and went on to win multiple research prizes and research grants, becoming a professor in 2006.

"Besides the money, which allows me to expand my research, it’s the feeling that our work is valued"

Now, having secured the BHF Chair at the end of 2012, she’ll receive an extra £900,000 towards her work on understanding the causes of and developing potential new treatments for atrial fibrillation (AF), an abnormality of the heart rhythm that can increase the risk of stroke and heart failure.

“It was such fantastic news,” she says. “I threw a party for colleagues and everyone in the lab. The BHF has supported my work for years and I’m so grateful for this. Besides the money, which allows me to expand my research, it’s the feeling that our work is valued.”

Vital research

Part of her research includes a clinical trial on 1,500 patients who have had heart surgery to bypass blocked arteries, restoring blood flow. The aim is to see whether a short course of high-dose statins, from just before to just after the surgery, will protect the heart muscle and reduce the risk of developing AF.

Barbara Casadei with a colleague in the lab“Patients who’ve had heart bypasses are at a much higher risk of developing AF during the first week after surgery. AF slows their recovery and raises the risk of complications such as heart failure and stroke,” explains Barbara.

“Major surgery causes high levels of inflammation that can be sensed by the heart and are linked to an increase in the production of substances called reactive oxygen species [ROS]. Our initial findings indicate that excess quantities of ROS in the heart muscle increase the risk of cardiac problems such as AF. Statins, which are currently used to help prevent heart attacks by lowering cholesterol, have the additional benefit of inhibiting ROS.

Our trial will test whether this latter effect of statins is also benefiting patients by reducing the risk of AF and heart muscle damage around the time of surgery.”

Some of the research will be conducted in Beijing, China, where the average age for a bypass is about late 50s, approximately ten years younger than in Oxford. “The fact that 65 per cent of the male Chinese population smokes compared with 21 per cent in the UK is likely to be a significant factor in this age difference,” says Barbara.

"Nothing beats the excitement of seeing something happen for the first time in the lab"

So how much has working in heart health and having access to such stats influenced her lifestyle?

“Hugely,” she says, without hesitation. “In countries where a high number of women smoke, a higher proportion have heart attacks in their 50s – that’s especially young for a woman.”

But with her long list of commitments and punishing schedule, is it sometimes difficult to follow a healthy lifestyle?

“I cook from scratch but I have a rule that nothing must take longer than 30 minutes, so it’s simple food like grilled fish and salad. Seafood risotto is one of my favourite Italian dishes,” she says. “I also cycle to work, go to the gym at the weekend and swim.” But she admits that it hasn’t always been easy. “When my daughter Isabella, now 18, was younger, I didn’t have time to do much exercise as I work such long hours.”

Being so busy all the time must be exhausting. Does it ever get too much? “It’s a lifestyle, not a job,” she concedes. “But I love it and that’s motivating. Nothing beats the excitement of seeing something happen for the first time in the lab.”

Her home must be a very motivated – and high-achieving – environment. Barbara’s partner is another BHF Chair, Professor Sir Rory Collins, who’s also at Oxford, one of the UK’s four BHF Research Centres of Excellence, which are benefiting from a six-year investment strategy to secure the UK’s future as a world-leading force in heart research.

There are currently 30 BHF Chairs in the UK, Barbara being the only woman. In fact, she’s only the third-ever female professor in the BHF’s 50-year history to receive this title.

“At the age when a scientist should make the transition towards an independent academic career, women often have young children and feel they cannot take more time away from their families,” she says. “Because of this, they can get stuck at a certain level in their career and lose confidence. And because there aren’t so many women at a really high level in the field, younger women may start to doubt that they can make it. Women in science are a minority group with all the disadvantages that come with it.”

Nevertheless, she’s confident that the balance will eventually be redressed. “For years, we hardly saw a female trainee in the department; now 30 per cent of the cardiology trainees are women.”

Goals for the New Year

Barbara CasadeiOne of Barbara’s New Year’s resolutions is to continue to be involved in the Athena Swan Charter – a scheme that promotes the careers of women in science, engineering and technology. “I have had a lot of joy and satisfaction through my work and have fantastically supportive colleagues, so I know how important encouragement and mentorship can be.”

On that note, she’s off to patiently pose for the photoshoot as though it’s all in a day’s work. Something makes me think that her lucky trainees couldn’t have a better role model.

Read more about women and science in our interview with Professor Alice Roberts

Read more about atrial fibrillation

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