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

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

If you have coronary heart disease, youre twice as likely to have a stroke or to develop vascular dementia, which happens when theres a problem with the blood and oxygen supply to the brain. Picture: PA

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.

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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.

James Cant, Director, British Heart Foundation Scotland

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 individuals 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 understanding 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 people don’t have to spend years of their life suffering from several long-term, debilitating conditions or, even worse, dying from them.

BHF-funded research has helped to transform survival rates from heart and circulatory diseases in Scotland, but they still kill one in four people, causing heartbreak on every street. Our work is as urgent and vital as ever.

With your support, we can continue to fund innovative research to keep hearts beating and keep blood flowing. And together, we can beat heartbreak for Scotland.

James Cant, director, British Heart Foundation Scotland