Dr Stephanie Si­monds is chang­ing the way women are treated for obe­sity-re­lated heart disease. She tells Jaymie Hooper why this is a cause worth fight­ing for

The Sunday Telegraph (Sydney) - Body and Soul - - HEALTH -

Here’s a puz­zling fact: Al­though heart disease is the num­berone cause of death for men and women world­wide, most of the re­search into the disease fo­cuses on men. The dis­crep­an­cies don’t end there, ei­ther. While ex­cess body fat con­trib­utes to about 70 per cent of all heart disease cases, the link doesn’t re­ceive the re­search at­ten­tion it de­serves. Thanks to Aus­tralian sci­en­tists like Dr Stephanie Si­monds, a 30-year-old car­dio­vas­cu­lar re­searcher at Monash Univer­sity in Mel­bourne, that’s about to change.

De­spite only work­ing in the field for a rel­a­tively short time, Stephanie’s re­search has al­ready gained in­ter­na­tional at­ten­tion. She be­came fas­ci­nated by the heart in her se­cond year of univer­sity, and be­gan her PhD at 22, dur­ing which she suc­cess­fully demon­strated the im­por­tant link be­tween obe­sity and heart disease. Her PhD find­ings were pub­lished in the pres­ti­gious jour­nal Cell in 2014 and her study was the first to show that when ex­cess lep­tin (a hor­mone se­creted by fat cells) ac­cu­mu­lates in the brain, it causes a rise in blood pres­sure and heart rate, which in turn in­creases the risk of heart disease.

It was this find­ing that saw Stephanie granted the 2016 Vic­to­rian Pre­mier’s Award for Health and Med­i­cal Re­search. And thanks to her ground­break­ing dis­cov­ery that oe­stro­gen may pro­tect obese women from lep­tin’s ef­fects, she was last week named a 2017 L’Oréal-UNESCO for Women in Sci­ence Aus­tralian Fel­low, al­low­ing her to con­tinue her re­search.

“When women go through menopause, they lose oe­stro­gen, so when I found that pre-menopausal women weren’t de­vel­op­ing high blood pres­sure at the same rate as men were, I thought, there’s some­thing here. Oe­stro­gen has been known to have an ef­fect on the ves­sels in our body, but what we found was that it also pre­vents the ef­fects of lep­tin in obese women.”

Un­der­stand­ing ex­actly how oe­stro­gen blocks lep­tin from rais­ing blood pres­sure lev­els is the key to un­lock­ing new treat­ment op­tions, and thanks to the re­cent fund­ing from L’Oréal, Stephanie is one step closer.

“Now that we know oe­stro­gen has an op­pos­ing ef­fect on lep­tin in the brain, we need to un­der­stand their re­la­tion­ship so we can iden­tify the cell type or sig­nalling path­way they act through,” she says. Once this path­way is dis­cov­ered, Stephanie hopes her team will be able to cre­ate a sin­gle tablet that obese women (and men) with heart disease can take. “It’s com­mon for peo­ple with obe­sity and heart disease to be on three or four med­i­ca­tions at a time, so if we can cre­ate some­thing that means they won’t have to take as many drugs, it will re­ally im­prove their quality of life.”

Of course, it may be a while be­fore such med­i­ca­tion is avail­able to the pub­lic, and stud­ies in­volv­ing obe­sity and the heart are never easy, but this is a case Stephanie’s de­ter­mined to crack. “Sec­ondary dis­eases like heart disease need to be ad­dressed, be­cause by the time we come up with a so­lu­tion for obe­sity, it might be too late for some peo­ple,” she says. “The treat­ments we cur­rently have for heart disease are good, but we need to in­vent bet­ter ones be­cause peo­ple are still dy­ing from it.” Throw in a dash of fe­male hor­mones, and Stephanie’s cur­rent study of obese women is even more com­plex – which is why fund­ing is key.

“We can’t do any­thing if we have no fund­ing, so a lot of peo­ple study men be­cause it’s eas­ier. The fe­male hor­mones

have such a big im­pact on body weight, so you re­ally have to mon­i­tor them and some peo­ple pre­fer to take the easy op­tion,” she says. “This means only half the pop­u­la­tion are re­ceiv­ing treat­ment for obe­sity and heart disease, though, and that’s the rea­son I’ve gone down this track.”

While in the past, ground­break­ing heart re­search has mostly oc­curred in other coun­tries, the early recog­ni­tion and fund­ing of Stephanie’s work has helped keep her in Australia. She’s proud to be do­ing this work in her home coun­try, and she’s de­ter­mined to make more dis­cov­er­ies.

“Even when we get the small­est re­sult, it makes me re­ally happy be­cause we un­der­stand a bit more. Some­times I do get tired when we don’t see what we thought we were go­ing to, but I keep try­ing be­cause if we can find a way to pre­vent obe­sity or heart disease, that would be the ul­ti­mate re­ward.”


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