The Scotsman

Playing a vital role at the heart of new research into circulator­y disease

The British Heart Foundation has led the way in transformi­ng survival rates in Scotland – but more needs to be done, writes James Cant

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What connects heart diseases, stroke, vascular dementia and diabetes? Your circulator­y system, and Bhf-funded research.

Despite what our name might suggest, at British Heart Foundation Scotland we’re not all about hearts. Our work covers so much more than that.

After more than 55 years of pioneering Bhf-funded research, we understand better than ever the connection­s between the heart and the rest of the body. Heart and circulator­y diseases happen when there’s a problem with your heart, or with the network of veins and arteries controllin­g blood flow around your body. It’s all connected. For example, we know that what’s happening in the veins in one part of the body affects the arteries elsewhere. Because if your heart isn’t pumping properly, and blood isn’t flowing properly, you’re at risk of developing serious conditions like heart diseases, stroke and vascular dementia and complicati­ons from conditions like diabetes.

If you have diabetes, your body can’t control its blood sugar levels. This damages the arteries and limits the flow of blood, meaning you’re more likely to develop coronary heart disease. Two-thirds of people with diabetes die from a heart or circulator­y disease.

If you have coronary heart disease, you’re twice as likely to have a stroke or to develop vascular dementia, which happens when there’s a problem with the blood and oxygen supply to the brain, causing part of the brain to die.

And if you have a stroke, when blood flow to part of the brain is blocked, you also have an increased risk of developing vascular dementia. One in ten stroke survivors is expected to develop dementia within a year of having their stroke, increasing to one in three within five years.

We recently commission­ed analysis that revealed that an astonishin­g 92 per cent of people in Scotland living with coronary heart disease have at least one other long-term condition, while nearly six in ten have at least three. Numerous studies have shown that living with multiple conditions significan­tly increases the risk of early death.

The analysis found that the most common comorbidit­y for the 231,000 Scots living with coronary heart disease is high blood pressure, which affects more than half (54 per cent) of them. A quarter have diabetes; 15 per cent have had a stroke and 5 per cent have dementia. These statistics are shocking and should give us all cause for concern. Behind the figures are thousands of affected indi- viduals and families, and a health and social care system under increasing pressure. They also show in the most compelling terms why the BHF funds research into all heart and circulator­y diseases. In fact, we always have done but now you’ll hear us talking about the breadth and range of our work a bit more. Because all these conditions are connected – so are their causes and so are their cures.

A good illustrati­on of these links is the research we’re currently funding by Professor Joanna Wardlaw at the University of Edinburgh, who is studying the small blood vessels deep in the brain. Problems with these blood vessels can lead to strokes and vascular dementia. Professor Wardlaw believes that stroke and dementia should be looked at together, and her project is jointly funded by the BHF, the Stroke Associatio­n and Alzheimer’s Society.

Her team will collect informatio­n from hospital records and perform thinking and memory tests on 2,000 people after they have had a stroke. They will also collect biological samples (like blood) and perform scans that will help to identify chemicals that could act as markers for vascular

dementia. The researcher­s will compare results from those who develop memory and thinking problems with those who don’t, using the results to try to work out what causes vascular dementia and how to predict those at risk of developing the condition.

But more research is urgently needed to improve our understand-

ing of how conditions like heart diseases, diabetes, stroke and vascular dementia are connected, and to develop new treatments for people living with multiple conditions. It’s only through increasing our understand­ing of what causes these conditions, and how best to treat them, that we can ensure that thousands of

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0 If you have coronary heart disease, you’re twice as likely to have a stroke or to develop
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