Featured: The Heart

3-6a

That obesity is a leading cause of heart disease, stroke, and hypertension is well-known. But Professor Kenneth Walsh, director of the Whitaker Cardiovascular Institute at Boston University School of Medicine, wanted to understand precisely what happens in the body to link obesity to these and other diseases. To find answers, he created a muscle-bound mouse.

Walsh and his colleagues were able to genetically program mice, activating a gene that promotes growth of muscle fibers that typically build up in weight training. The mice gained strength, lost fat, and showed signs of metabolic improvement throughout their bodies—even though they did not exercise more and were fed a diet high in fat and sugar. When the researchers deactivated the gene, the mice returned to their original condition.

The discovery has implications for strength training as a prescription for health in humans, especially those with obesity. And it is an important step—one of many taken at Boston University School of Medicine—toward understanding the mechanisms that underlie cardiovascular disease.

“We are becoming a center of excellence for studying how metabolic dysfunction affects cardiovascular disease at a deep molecular level,” Walsh says. “This is really important today. These are the big drivers of cardiovascular disease.”

Boston University School of Medicine is home to sixty years of breakthroughs in cardiac care.

From analyzing clinical care procedures to advanced research at the molecular and cellular levels, BUSM is a world leader in investigating the causes of cardiovascular disease and its diagnosis, treatment, and prevention. The medical school has been responsible for some of the most important discoveries in the history of cardiovascular medicine.

In 1949, for example, Professor Robert W. Wilkins was the first researcher to identify a drug that lowered blood pressure—a discovery that would change forever the treatment of hypertension. The famed Framingham Heart Study, which the medical school has co-directed for forty years, identified the role of cholesterol and lifestyle factors in cardiac risk.

Collaboration translates basic research to patient care

Heart research at the medical school is centered at the Whitaker Cardiovascular Institute, which houses ten major laboratories and about a hundred researchers. Collaborative research is the hallmark of the institute, one of the world’s leading cardiovascular research centers.

Some researchers at the Whitaker Institute, like Dr. Walsh, are molecular biologists studying basic cardiovascular function with animal models. When these researchers identify molecular functions they believe are important, they work with clinical researchers to see if the findings can be applied to humans.

“If you just do pure basic research, it’s hard to know what it means clinically,” says Professor Joseph Vita, senior staff cardiologist. “If you work with mice and then with humans on the same molecular pathways, you get insight into their clinical importance.”

Discoveries moving closer to a cure

A primary area of research at the Whitaker Institute is diabetes and obesity and how they are linked to heart disease. Investigators are discovering how tissues in the body send information to the heart and blood vessels. This promising field could someday produce therapies that might alter the process by which diabetes and obesity contribute to heart disease.

“The research is leading to a lot of drug targets,” says Professor Walsh. “Not everything will produce a drug, but we are developing a profound understanding of how the cardiovascular system works normally and what happens when it malfunctions.”

Other researchers at the medical school are identifying how certain foods—including tea, grape juice, and cranberry juice—affect the vascular system and why a Mediterranean diet, rich in fruit and vegetables and healthy fat, may promote cardiovascular health. Other teams are investigating oxidative stress, an imbalance in the body in which molecules called free radicals cause damage to cells, tissues and organs.

Treatment that works

Several years ago, researchers at the School of Medicine recognized a problem: Participation rates at cardiac rehabilitation programs are shockingly low. Cardiac rehabilitation is one of the great medical success stories of the last 50 years: these exercise and education programs are proven lifesavers for people who have had heart attacks. Patients who undergo cardiac rehab dramatically reduce their risk of future heart disease.

But according to national surveys, about 20 percent of heart attack victims complete a program. A research team led by medical school Professor Gary Balady decided to find out why.

The researchers analyzed how hospitals refer patients to rehab programs. They interviewed patients, doctors, nurses, physical therapists, and rehab staff. The team found that patients often are overwhelmed with information when they are discharged. Many don’t even know they’ve been referred to cardiac rehab. And rehab programs often don’t know a patient has been referred to them.

In light of these findings, the American Heart Association launched a major initiative to find solutions and asked Professor Balady to lead it. Some hospitals already are revamping procedures, making sure patients get clear instructions about cardiac rehab and that rehab agencies are notified when a patient is referred to them.

“We believe programs also may need to be redesigned and tailored to the needs of individual patients,” says Balady, who the American Heart Association named its 2010 Physician of the Year.

More to be done

Despite all of the advances in diagnosis and treatment, cardiovascular disease remains a large and growing problem. It is the leading killer of both men and women in the United States and the world. Heart disease is responsible for 40 percent of deaths in the United States—more than all forms of cancer combined. But the many and varied approaches to heart research at BUSM hold great promise for prevention and treatment.

Sample giving opportunities

  • Create and name an endowed professorship for the faculty of the program: $1.25 million for an assistant professor, $2.5 million for a full professor
  • Endow a research fund: $100,000
  • Endow a scholarship for a BUSM student: $100,000
  • Endow a postdoctoral fellowship: $100,000
  • Create a current-use fellowship award: $10,000
  • Provide unrestricted support as a member of the BUSM Dean’s Club: $1,500 and above