WHEN the British Heart Foundation was founded sixty years ago by a group of cardiologists, the standard treatment for a heart attack was bed rest.
“Not surprisingly, most people died,” says Professor James Leiper, of the Institute for Cardiovascular and Medical Sciences at The University of Glasgow.
The advances in the treatment of cardiovascular disease and birth heart defects would have been un-imaginable at the time, he says. Most have been driven by Scots scientists.
The development of the cholesterol lowering drug statins, a treatment that has saved millions of lives, globally was pioneered in Edinburgh.
More recently, Scotland, along with Wales, has also led the way in changing organ donation laws to help increase the number of heart transplants that are possible.
The UK’s first dedicated coronary care unit for heart attack patients was also developed at a Scottish hospital.
READ MORE: The public health change credited for a 74% drop in heart attacks in Scotland
“Most people now, survive,” says Prof Leiper. “We have turned that around completely.
“And that’s been in part, thanks to the pioneering work of the BHF nationally but Scottish researchers have played a big role in that.
“Scotland punches above it’s weight in terms of cardiovascular research in the UK.
“We have really excellent researchers and they produce some of the best research, internationally.”
In 1967, Desmond Julian, an Edinburgh cardiologist, was studying heart attacks and realised that bed rest was “completely inadequate” as a first line treatment.
His research led to the development of the UK’s first dedicated coronary care unit at Edinburgh Royal Infirmary.
“That was ground-breaking at the time,” says Prof Leiper. “From that, we now have a UK-wide programme of excellent coronary care units.
“Heart attack is an acute condition and treatments need to be administered acutely in order to preserve the heart and increase survivability and increase their quality of life.”
Professor Julian CBE went on to become medical director for the charity and died in 2019 at the age of 95.
Another Scots scientists, Professor Michael Oliver, carried out the first study that proved high levels of cholesterol in the blood caused coronary artery disease.
“We are all aware that cholesterol is bad for us and we need to lower levels but if you go back into the 1970s, there was a thought that it was bad for us but there really wasn’t any hard evidence.
“So Professor Oliver conducted the first study that provided the first evidence that cholesterol causes coronary artery disease. This was absolutely critical because this takes it from just being hearsay - you don’t want to eat too much fat - to hard evidence that can be actioned.
“And that evidence led to the development of statins. Statins now are one of the most widely used drugs, globally and that first study in 1978 by Professor Oliver, really laid the foundations and statins have saved millions of lives around the globe.
“Another great example where Scottish scientists really paved the way for global changes in the way that we treat cardiovascular disease.”
He says the burden of heart disease in Scotland has “played into” the country’s research achievements.
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“But there are other reasons why Scotland punches above its weight," he added. "We have two or three very highly rated universities, Glasgow, Edinburgh and St Andrews,that are highly ranked internationally.
“Those universities have the ability to attract the best scientists. In recognition of that the BHF has funded two centres of research excellence in Scotland in Glasgow and Edinburgh that provides a high level of funding over a long period of time to allow those universities to invest in the brightest and the best in cardiovascular science.
“It allows the brightest Phd students to come all the way through to the point that they may become BHF-funded professors of cardiovascular medicine.
“The UK only funds six of these in the UK so Scotland has a third of them, which is way above the population base.”
In common with most other charities, the pandemic has had a seismic impact on the fund-raising that sustains its life-saving research.
The virus itself has thrown up new challenges for heart health.
Doctors at the Golden Jubilee Hospital in Clydebank issued a warning about heart attack patients delaying emergency treatment during the first lockdown, which they said was leading to poorer outcomes.
READ MORE: Record number of Scots want to learn CPR after Christian Eriksen's collapse
A BHF-funded study showed that around half of 1216 patients who received a heart scan while in hospital due to Covid-19 showed abnormalities in their heart function, with around one in seven showing severe abnormalities.
Patients affected by Long Covid have been diagnosed with Myocarditis, which causes inflammation of the heart muscle and the condition has also affected some, younger men who received the Pfizer vaccine.
“It’s interesting to reflect on the achievements of the past 60 years because this year has probably been the most challenging year, ever,” says Prof Leiper.
“But because the BHF has been building infrastructure for the past 60 years, it has put itself in a good position to help people with cardiovascular disease in the last 12-18 months, when it’s been needed more than ever.
He says there is still a “huge un-met clinical need” in the treatment of heart failure.
Researchers are also aiming to develop the first mechanical heart.
“We are investing in research into preserving and re-generating the heart following a heart attack and this is really exciting cutting-edge science where we are talking about either gene therapy or stem cell therapy approaches.
“Transplantation is the last option that one wants to use. It’s a hugely invasive and complex surgery. There are not enough organs for transplant but Scotland has also led the way here, in the opt-out system, and the BHF is very proud to have influenced that change.
“If we can re-generate a patient’s heart that’s a fantastic way to go.”
The British Heart Foundation will mark its 60th anniversary on July 28, celebrating decades of pioneering work that also led to the first heart transplants and pacemakers, which at one time required complex surgery and electrodes being fitted to the heart but can now be fixed in minituare in a straightforward procedure.
“We are incredibly proud of what we have been part of over the past sixty years," says James Joplin, head of BHF Scotland. "We couldn’t have done it without the donations, the shoppers, the volunteers up and down the country who have helped us get there.”
While the Scottish Government has produced a new strategy to tackle heart disease, which was welcomed by the charity, Mr Jopling says the funding “is not what we would have hoped for” amid a backdrop of £60million losses over the past year.
“We are fully aware that we are in a world influenced by Covid in a way we could never have imagined but people still get and develop heart conditions so we can’t let those people down.
“I think from our perspective, in terms of the research we fund, we are doing everything we can to recover our income as quickly as possible but we do feel that we need the government to work with charities, researchers and universities to ensure that our research environment is sustainable, not just for heart disease but for cancer, lung disease and diabetes.
READ MORE: Scotland could become world leader in heart defect treatment after prestigious appointments
“In all of these fields, it’s charities who fund substantial amounts of work and its the public who fund those charities to do it.
“We can’t close that gap as quickly as we would like.”
Suzanne Algeo, from Ayr, is helping the charity close that gap.
The 38-year-old was diagnosed with Long QT Syndrome two days before her 30th birthday, a condition that causes abnormal heart rhythms and can be fatal.
Recalling the day of her diagnosis, Suzanne, said: “At the time I was experiencing intense palpitations and feeling like I was going to pass out.
“Being told particular triggers were cold water, swimming and intense exercise, my birthday plans for an inflatable assault course on Loch Lomond followed by a week in a fitness resort were swiftly cancelled!
Six months later, genetic testing confirmed she had inherited the condition.
Her grandmother had been diagnosed with LQTS in later life.
Since then, the mother-of-one she has learned to cope with her condition, taking daily medication which she says allows her to live a fairly normal, active life.
However, she was “floored” after her son Zachary was diagnosed with the condition, after his birth last year.
Throughout March she ran and walked100km for the BHF, raising more than £1,800.
She said: “I had always planned to fundraise to support further research and Zachary’s diagnosis spurred me on to do something to help.”
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