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Seven discoveries that hit the headlines at the world's biggest heart conference
The European Society of Cardiology (ESC) Congress was back with a bang this year, bringing experts from around the world together in Barcelona for the first time since 2019. This year marked 70 years since the first ESC Congress and, as usual, the conference was bursting with breakthroughs in heart and circulatory diseases research. Here are seven things we learnt.
Blood pressure medication is effective at any time of day
Back in 2020 a study was published suggesting that blood pressure lowering medication was more effective if taken in the evening.
But now, results of a study we have funded have revealed that time of day doesn’t impact how effective blood pressure lowering medication is. Over 20,000 people took part in the Treatment in Morning versus Evening (TIME) study – half were asked to take their blood pressure lowering medication in the morning and the other half in the evening.
Everyone involved was followed up for an average of five years. The results showed that there was no difference in the number of people who had a heart attack, stroke or died whether they look their medication in the morning or the evening.
Professor Sir Nilesh Samani, our Medical Director, said: “This is important news for the millions of people in the UK who take medication to lower their blood pressure. These results show that the time of the day people take their blood pressure tablets does not matter and they should take them at the time that suits them best."
Statins aren’t the cause of most reported muscle pain
Statins are among the most prescribed medications in the UK, with up to eight million adults taking them to reduce levels of low density lipoprotein (LDL, also called ‘bad’) cholesterol in their blood. But side effects, particularly muscle weakness or pain, are reported by many people who take statins.
With funding from us, a team led by researchers at the University of Oxford have compiled data from 23 large studies into statins involving nearly 155,000 people. The results presented at the conference showed that statins aren’t the cause of muscle pain in over 90 per cent of people who experience symptoms.
Professor Sir Nilesh Samani, our Medical Director, said: “It is vital that the genuine concerns of people who do experience muscle symptoms are not dismissed and that doctors have continued consultations with these patients to ensure their medication is tailored to work best for them.”
Artificial intelligence could help to narrow the heart attack gender gap
We’re previously reported that women receive poorer heart attack care than men at every stage, with women 50 per cent more likely to receive a wrong initial diagnosis.
But now, an algorithm developed using artificial intelligence (AI) could help to diagnose heart attacks in women more quickly and accurately. Researchers we fund from the University of Edinburgh used routinely collected data from over 10,000 people who went to hospital with a suspected heart attack to develop their AI based tool, called CoDE-ACS. It combines a patient’s troponin levels (the gold standard way of diagnosing a heart attack) with information about them (sex, age, observations, ECG findings and medical history).
They found that CoDE-ACS could rule out a heart attack with 99.5 per cent accuracy, confirming that patients were safe to go home. It also identified those who would benefit from staying in hospital for further tests, in whom the final diagnosis was a heart attack, with an accuracy of 83.7 per cent.
BHF Professor Nick Mills said: “Our mission is to fast-track improvements in heart attack diagnosis, and we hope our CoDE-ACS app will be rolled out in Emergency Departments across the UK to deliver more personalised care and better outcomes.”
A remote alert system could help reduce heart failure hospitalisations
A remote heart failure remote alert system, developed by researchers we fund at Manchester University NHS Foundation Trust and the University of Manchester, can dramatically reduce the number of hospitalisations and improve patient care with minimal staffing time.
Almost one million people in the UK live with heart failure. Those with the most severe forms of the condition may be fitted with pacemakers and implantable cardioverter defibrillators (ICDs). The system, called ‘TriageHF Plus’ uses information routinely collected by these devices, including heart rate, heart rhythm, physical activity, and fluid build-up in the lungs. This is then automatically streamed to the hospital from the patient’s home.
The remote alert system notifies doctors and nurses when a person’s condition becomes ‘high risk’ of them being hospitalised within 30 days, prompting a phone consultation to assess their condition.
Dr Joanne Taylor, BHF Clinical Research Fellow at the University of Manchester, said: “People with heart failure tend to come to hospital for checks every six months, but for some their condition can decline rapidly between appointments. The beauty of this remote alert system and our pathway is that it immediately issues an alert in real time when a potentially significant change in the patient's health related data is detected, at a time when the patient may be deteriorating. This means we can strike while the iron is hot and intervene early to prevent them getting too ill and being hospitalised.”
Combo of drugs could delay need for surgery in people with Marfan syndrome
Marfan syndrome causes problems with the connective tissue in their bodies, and this can cause people with the condition to have weak blood vessels. One of the most serious complications is weakness of the aorta, the main blood vessel that carries blood away from the heart. Over time the aorta can expand, increasing the risk that it will tear or burst. If this does happen it requires immediate, lifesaving surgery.
People with Marfan syndrome are closely monitored to keep track of the size of their aorta. They will be offered surgery if the vessel becomes too large, however this is still high-risk and recovery can take months.
Now, researchers from the University of Oxford have found that a combination of two drugs – beta-blockers and angiotensin receptor blockers – can slow down how quickly the aorta grows and delay the need for surgery.
Shona Cobb, 25, lives with Marfan syndrome. She said: “These results are amazing news for people with Marfan syndrome... to be told that taking a couple of tablets a day could delay the need for surgery is an opportunity I would grab with both hands.”
Just 10 minutes walking a day could help the over 85s live longer
Adults are advised to do at least 150 minutes of moderate intensity activity (such as walking, cycling or swimming) every week. But we know that as people age their activity levels fall.
Researchers from the Republic of Korea investigated links between activity levels and risk of death in 7000 people aged 85 and over. They found that those who walked for at least one hour every week had a significantly lower chance of dying compared to people who did no walking.
Chloe MacArthur, our senior cardiac nurse, said: “It’s never too late to get active. Start small and try to incorporate more movement in your day-to-day life, whether that is doing the housework, gardening or popping out for a quick stroll. For anyone who isn’t mobile, chair-based exercises that can be completed at home can also be beneficial. You’ll find that those active minutes soon start to add up.”
A 'polypill' could prevent further heart attacks and strokes
When someone has a heart attack, they are prescribed several different medications to lower the risk of a further cardiac event. Now, a new study suggests that combining these drugs into a single pill could be more effective.
The ‘SECURE’ trial involved around 2,500 people who had a heart attack less than six months ago. Half were randomly chosen to take a ‘polypill’ containing aspirin to prevent blood clots, a cholesterol-reducing drug called atorvastatin, and ramipril, which lowers blood pressure. The other half were assigned to receive usual care and took all three drugs separately.
Researchers then followed up with the patients after three years. They found that the number of deaths from heart and circulatory conditions, along with the number of further heart attacks or stroke, was lower in the group of patients that had taken the polypill. Patients in the polypill group were also more likely to continue taking their medication than those in the usual care group.
Professor Sir Nilesh Samani, our Medical Director, said: “This study shows that combining these drugs into a single ‘polypill’ may improve compliance and reduce future cardiac events, compared with taking the drugs separately. If these results are confirmed in other studies, a polypill may become the preferred way of giving these drugs to most patients after a heart attack.”
Award winning BHF scientists
Congratulations are in order for BHF-funded researcher and Chair of our Translational Awards Committee Professor Stefan Neubauer from Radcliffe Department of Medicine, University of Oxford. Professor Neubauer gave the Paul Hugenholtz Award Lecture in Innovation at the conference on MRI and CT for heart and circulatory imaging in the 21st century.
Congratulations also to our former Clinical Research Fellow (2019-21) Dr Alexandros Protonotarios from University College London and St Bartholomew's Hospital who won the Young Investigator Award in Clinical Cardiology at the conference for his work on inherited heart muscle diseases.
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