Heart and Vascular Diseases

Heart and vascular, or cardiovascular, diseases include conditions such as arrhythmias, coronary heart disease, heart attack, high blood pressure, congenital heart defects, vascular dementia, and stroke. The National Heart, Lung, and Blood Institute (NHLBI) supports research on the causes, diagnosis, treatment, and prevention of heart and vascular diseases, and the interplay of these diseases with other conditions such as diabetes, HIV/AIDS, obesity, or sleep disorders such as sleep apnea.

Research Making a Difference

Research Making a Difference

Those who have elevated depressive symptoms are at increased risk for heart disease."
For years, scientists have known about the relationship between depression and heart disease. At least a quarter of cardiac patients suffer with depression, and adults with depression often develop heart disease. What researchers now want to know is “why.”
Patient being examined in preperation for heart surgery.

WHY IT'S IMPORTANT

For more than 60 years, the NHLBI has led the fight against heart and vascular diseases. The NHLBI supports research to advance the understanding of and interventions for pediatric and adult heart and vascular diseases, including heart attack, heart failure, stroke, and congenital heart disease. Over this period, steady, long-term investments in biomedical research have contributed to a 71 percent decrease in death rates due to coronary heart disease, yet more remains to be done. Heart disease is still the leading cause of death for men and women. The NHLBI has a long history of groundbreaking research in treatments for high blood pressure, a common condition that increases the risk for heart disease and stroke, two of the leading causes of death for Americans.

KEY ACCOMPLISHMENTS

  • NHLBI research helped understand the causes, prevention, and treatment of heart disease and reduced death rates from coronary heart disease by 71 percent.
  • The SPRINT study found that intensive high blood pressure treatment in people 50 years or older reduces heart events and the risk of death from such events.
  • The RAID Trial found that a drug to treat angina reduced the risk of rapid heart rhythms that may otherwise require an implantable cardioverter defibrillator.
  • The CLEVER Trial led the Centers for Medicare and Medicaid Services to reimburse supervised exercise therapy for a form of peripheral artery disease.
  • For more than a decade, the NHLBI’s Pediatric Heart Network has improved the care of children with heart diseases.
  • The Pediatric Cardiac Genomics Consortium identified a link between gene mutations that lead to congenital heart disease and neurodevelopmental abnormalities.

OPPORTUNITIES & CHALLENGES

The NHLBI will continue to build on its successes as it aims to better understand how to prevent, diagnose, and treat heart and vascular diseases. In 2016, NHLBI released its Strategic Vision, which will guide the Institute’s research activities for the coming decade. Many of the objectives, compelling questions, and critical challenges identified in the plan focus on heart and vascular biology and diseases. Training the next generation of heart and vascular scientists is also a high priority for the NHLBI. Learn more about how we are strategically moving research forward to improve health.

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Scientific advances have created opportunities to create a future in which we have an improved understanding of the complex interplay of environmental, behavioral, and molecular factors that promote heart and vascular health; detect heart and vascular diseases in their earliest stages before they cause symptoms; to prevent disease progression; repair defective or damaged hearts with stem cell and tissue engineering techniques; and generate new therapeutics for chronic conditions, such as heart failure and high blood pressure.

The NHLBI will continue to pursue opportunities to improve our understanding of how heart and vascular diseases impact women and diverse populations. For example, researchers have learned that women are more likely than men to have coronary microvascular disease, which affects the tiny arteries in the heart. Our research also seeks to address health disparities related to heart and vascular diseases, including high blood pressure and heart disease. Read about how the NHLBI is advancing research on Women’s HealthPopulation and Epidemiology Studies, and Health Disparities.

NHLBI is also studying the complex interplay of heart and vascular health and disease in the following research areas.

  • Child Health: The NHLBI supports heart and vascular disease research and programs to improve outcomes and quality of life for children, including work on heart and vascular diseases that are present at birth and that develop during childhood.
  • Heart-Healthy Aging: The NHLBI supports research on healthy aging to help more people live longer lives free from heart and vascular diseases.
  • Immunology, Virology, and AIDS: The NHLBI supports research to help understand the role of the immune system in heart and vascular disease and how having HIV/AIDS influences heart and vascular disease prevention and care.
  • Obesity, Nutrition, and Physical Activity: The NHLBI supports research on how lifestyle choices related to eating patterns and physical activity contribute to heart and vascular disease.
  • Sleep Science and Sleep Disorders: The NHLBI supports research on the interplay of sleep disorders such as sleep apnea, and heart and vascular diseases, such as high blood pressure and heart disease.
  • Women’s Health: The NHLBI supports research on heart and vascular health in women to reduce disparities that increase their prevalence and burden in women and resulting disorders that impact total health and wellbeing.

Advancing the Research

The NHLBI is advancing heart and vascular diseases research in many ways. Learn about some of the NHLBI’s efforts to support research on heart and vascular diseases.

We Perform Research

The NHLBI Division of Intramural Research (DIR) and its Cardiovascular Branch conducts research on diseases that affect the heart and blood vessels. Specific projects aim to answer clinically relevant questions in diagnostics, therapeutics, and interventions. Other DIR groups, such as the Systems Biology Center, perform research on heart and vascular diseases.

We Fund Research

NHLBI’s Division of Cardiovascular Sciences supports research to advance our understanding of and interventions for pediatric and adult cardiovascular diseases. It also supports the development of innovative technologies to diagnose, prevent, and treat heart and vascular diseases. The Center for Translation Research and Implementation Science supports research to translate these discoveries into clinical practice.

The Promise of Precision Medicine

Through NHLBI’s Trans-Omics for Precision Medicine (TOPMed) program, researchers will use data from studies focused on heart, lung, blood and sleep disorders to better predict, prevent, diagnose, and treat diseases based on a patient’s unique genes, environment, and molecular signatures. Learn more about NHLBI precision medicine activities.

Studying Innovations to Improve Heart and Vascular Disease Outcomes

The Cardiothoracic Surgical Trials Network (CTSN) is an international clinical research enterprise that studies heart valve disease, arrhythmias, heart failure, coronary heart disease, and the complications of surgery. The trials spans from early translation to the completion of six randomized clinical trials, three large observational studies, and many other studies with more than 14,000 participants.

Supporting Heart Failure Research Collaboration

The Heart Failure Clinical Research Network (HFN) conducts clinical trials to evaluate treatments for acute and chronic heart failure. The HFN brings together nine Regional Coordinating Centers and additional clinical sites in the United States to form a collaborative platform to research strategies that address the increasing public health burden of heart failure.

Supporting Child Health Research Collaboration

The Pediatric Heart Network (PHN) involves hospitals in the United States and Canada that conduct studies to improve outcomes and quality of life in children with congenital or acquired heart diseases. The PHN and its companion consortia, the Cardiovascular Development Consortium and the Pediatric Cardiac Genomics Consortium, make up the Bench to Bassinet program and cover basic to complex clinical research. The PCGC has recruited 13,477 children with CHD, as well as 18,269 parents, to assemble one of the world’s largest CHD registries. Whole genome sequence data from the PCGC have shed considerable new light on the causes of CHD and are helping inform clinically available genetic tests.  These data sets are also being combined with clinical outcome data to help inform the development of precision medicine strategies for CHD. 

Promoting a Clinical Trial Network to Address Emergency Medicine

The Resuscitation Outcomes Consortium (ROC) is a clinical trial network that tested treatments to address high morbidity and mortality rates from out-of-hospital cardiac arrest and severe traumatic injury. The trans-NIH Network for Emergency Care Clinical Trials: Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN) will conduct trials to improve outcomes in emergency departments and pre-hospital settings.

Addressing Barriers to Early Diagnosis and Treatment

The Vascular Interventions/Innovations and Therapeutic Advances (VITA) Program is a translational program that supports and accelerates early stage development of promising diagnostics and treatments. VITA seeks to address unmet clinical needs for vascular diseases, particularly in underserved medical communities.

Advancing Research on Conditions in People Living with HIV

In 2019, the NHLBI became the primary steward of the new Multicenter AIDS Cohort Study (MACS) / Women’s Interagency HIV Study (WIHS) Combined Cohort Study (MACS/WIHS-CSS). This study is a trans-NIH collaborative research effort that aims to understand and reduce the impact of chronic health conditions that affect people living with HIV. The MACS/WIHS Combined Cohort Study will build on decades of research in thousands of men and women who are living with and without HIV to further our understanding of chronic heart, lung, blood, sleep, and other disorders in people living with HIV.

Informing Improvements to Clinical Care and Public Health

The Systolic Blood Pressure Intervention Trial (SPRINT) showed the benefit of lower blood pressure targets to reduce heart and vascular diseases and death. The SPRINT Memory and Cognition in Decreased Hypertension (SPRINT-MIND) Trial studies the effect of this treatment on cognitive function in adults 50 years or older. SPRINT results influenced clinical guidelines, which will improve care for millions of people.

Determining the Most Effective Therapies to Manage Stable Ischemic Heart Disease

The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) is a 5,000-participant, 350-site international trial comparing invasive and conservative strategies to prevent heart and vascular events in patients with stable ischemic heart disease. ISCHEMIA and ISCHEMIA-Chronic Kidney Disease Trial (ISCHEMIA-CKD) results will inform future clinical care.

Providing Information About Treating Risk Factors for Heart Disease

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was a large study that enrolled people with high blood pressure and high blood cholesterol, two major risk factors for heart disease. The trial had two parts: a blood pressure study and a cholesterol study. ALLHAT’s findings have informed how we treat high blood pressure and high blood cholesterol.

Providing Access to NHLBI Biologic Specimens and Data

The Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) centralizes and integrates biospecimens and clinical data that were once stored in separate repositories. Researchers can find and request available resources on BioLINCC's secure website, which maximizes the value of these resources and advances heart, lung, blood, and sleep research.

A Registry of Medical Information to Advance Research in Thoracic Aortic Aneurysms

From 2006 to 2016, the NHLBI and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) co-funded the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC). The GenTAC Registry includes medical data, clinical images, and biological samples from over 3,600 patients. Launched in 2017, NHLBI’s GenTAC Alliance is providing leadership and expanding collaborations to address research and education needs, and advance clinical care of individuals who have genetically triggered thoracic aortic aneurysms.

Supporting scientists performing NHLBI-funded gene therapy research

Research on genetic therapies is part of our broader commitment to advancing scientific discovery aimed at developing safe and effective treatments for heart, lung, and blood disorders and diseases caused by faulty genes. Our National Gene Vector Biorepository and Gene Therapy Resource Program help investigators transform early-stage research into genetic therapies. These programs equip scientists with the tools, resources, safety testing services, and animal models they need to advance genetic therapy research from the laboratory into clinical trials.

Facilitating multinational cardiovascular clinical trials

The Global Cardiovascular Research Funders Forum Multinational Clinical Trials Initiative enables investigator-led multinational clinical trials by providing a way for researchers to submit a single proposal for consideration by international funders. The goal is to help researchers in different countries collaborate more effectively and plan ambitious, practice-changing clinical trials that deliver results successfully.

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