Personalised medicine: what is it, and how does it work?

What’s on this page?

• What is personalised medicine?
• How does personalised medicine work?
• BHF-funded research into personalised medicine
• Creating 'virtual' hearts to predict treatment success
• Personalised pacemakers
• Using personalised medicine to prevent heart attack and stroke
• Predicting the impact of chemotherapy on the heart

What is personalised medicine?

Personalised medicine, sometimes referred to as precision medicine, is the process of tailoring medical decisions and interventions to an individual person. It’s about moving away from the one-size-fits-all approach and instead customising treatments for individuals.

Imagine receiving a treatment carefully selected just for you, one that would minimise side effects, and give you the best possible outcome. Or receiving a more precise diagnosis based on your unique situation, and even being able to predict and prevent illnesses developing in the first place. This is what we hope to achieve with personalised medicine.

How does personalised medicine work?

We are all unique, and everyone’s genetic makeup is slightly different. There are common risk factors for heart and circulatory diseases, such as age, cholesterol levels, excess weight and whether you smoke. But our genes affect how much difference these risk factors make to each person. This means that some people develop heart or circulatory conditions, while others don’t, that the same disease will progress differently in different people, and people react differently to the same treatments.

When you’re diagnosed with an illness, the decision about which treatment you’re offered will be based on average results in tests on large numbers of people.

Personalised medicine isn’t just about prescribing the best drugs. It’s also about improving diagnosis, predicting the likelihood of someone developing a condition, and stopping a condition from getting worse.

As technology advances, scientists are able to analyse a range of data about our bodies, including genetic data. By combining genetic, clinical, medicines and lifestyle data we can find common factors and causes of variation, changing how diseases are thought of and treated.

BHF-funded research into personalised medicine 

The research we fund is helping to develop personalised medicine for those with and at risk of heart and circulatory diseases.

Creating 'virtual' hearts to predict treatment success

One way that BHF-funded research is leading to better, more personalised treatments is by using computer programs to study how the heart works and responds to treatments. This involves creating a digital version – a computer model – of someone’s heart, which could potentially be used to test different treatments and how they work for each person. This way individual treatment decisions can be made.

To be able to test the effects of different treatments in a virtual way, we need to know what the patient’s heart looks like and how it functions, so that the virtual model will be accurate. Dr Martin Bishop and his team at King’s College London (KCL) are finding out how much detail is needed to create personalised heart models. To work this out, the team are using existing heart scanning techniques and electrical activity data from patients’ hearts. This work has the potential to inform and guide future construction and use of virtual hearts for personalised treatment of abnormal heart rhythms.

Dr Steven Niederer, also at KCL, is using computer models of individual hearts to predict the best treatments for people with heart failure (a condition where the heart is not pumping blood as well as it should) and atrial fibrillation (AF – the most common form of irregular heart rhythm). Many people live with both these conditions, which makes treatment challenging because the treatment for AF may affect heart failure and vice versa. By developing computer models of the patient’s heart we hope to be able to predict which is the best treatment for an individual.

The process of creating a "digital twin” of the hearts of three patients to investigate heart rhythm problems. Starting with images captured from MRI scans (far-left column), more detailed information is added to the images moving left to right, such as the mapping of the heart’s electrical activity, helping researchers to find which regions to target (final column) to restore a normal rhythm.

• Learn more about our research into virtual heart models

Personalised pacemakers

Pacemakers can help the heart to pump blood more effectively for some people living with heart failure. These pacemakers can also increase heart rate during exercise (as your body would normally do if you don’t have a pacemaker). This is intended to make it easier for people to exercise. But this increase in heart rate is not tailored.

BHF-funded researchers Dr Sam Straw and Dr Klaus Witte at the University of Leeds have shown that this one-size-fits-all method does not always improve exercise capacity, possibly because it is based on how a healthy heart would respond to exercise. They are now looking at whether a personalised heart rate rise could help people to exercise, and slow down the deterioration of heart function. This research could provide new answers which could help patients live well for longer.

• Learn more about BHF-funded research into personalised pacemakers

Using personalised medicine to prevent heart attack and stroke

Platelets are small cells in our blood that help our body form clots that stop bleeding. However, in diseased blood vessels, they can trigger blood clots that block the blood vessel and cause a heart attack or stroke.

Antiplatelet drugs, such as clopidogrel and aspirin, make it less likely that platelets will stick together to form a clot, so can reduce the risk of heart attack and stroke. But they don’t work for everyone and can have serious side effects, such as bleeding.

These drugs are often prescribed on a one-size-fits-all basis, which doesn’t take into consideration that platelet response varies between people, which could affect how they respond to medicines.

We’ve been funding research into this at the University of Reading for 20 years, with £4.4 million in total funding1. Professor Jonathan Gibbins and his team have developed computer models to study platelets and characterise them based on different factors such as age or the particular proteins on the platelet surface. These factors could help us understand why some people do not respond to anti-platelet medicines. This research should lead to personalised and more effective ways to prevent or treat heart attacks and strokes.

Predicting the impact of chemotherapy on the heart

Improvements in cancer treatment mean that more people diagnosed with cancer are now living longer. But treatment side effects can cause long-term damage to the heart and blood vessels. A group of chemotherapy drugs called fluoropyrimidines can cause heart problems, such as chest pain, reduced blood flow to the heart and, in rare cases, sudden death.

Dr Charlotte Manisty and Dr Aderonke Abiodun at University College London are studying people who are starting this type of chemotherapy and assessing which of them develop heart problems and what they have in common. Understanding how heart problems arise during chemotherapy may reveal ways to spot people at risk of complications and how to protect them. This will enable them to receive personalised care to minimise heart problems during cancer treatment and improve their outcomes.

• Learn more about how chemotherapy can affect the heart

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