How a family history of heart disease and stroke drives the work of 3 Johnson & Johnson scientists

Roberta Chapman, M.D., a cardiologist and Vice President, Global Heart Failure, Heart Recovery, Johnson & Johnson MedTech, was three months into her first post-graduate job as director of a heart-transplant program when she received a life-altering phone call: Her mother had just been diagnosed with heart failure.

The news landed hard. Dr. Chapman’s mother had lived with her family for four years, helping look after her grandchildren as Dr. Chapman finished her medical training.

“It was very sobering,” says Dr. Chapman. “The most important woman in my life was living in my home and I never saw her at risk. I’m a heart-failure specialist; how could I have missed this?”

That watershed moment was “both a low point and a motivational point,” she says. It ultimately led her to become a strong voice in advocating for women facing cardiovascular disease (CVD) and a force for educating both the public and her fellow cardiologists about the biases and misperceptions that left her mother’s symptoms overlooked.

CVD—including stroke, heart failure and conditions such as atrial fibrillation (AFib)—is the leading cause of death globally, responsible for nearly one in three deaths. In the U.S. alone, that translates to one death from CVD every 34 seconds; around 1 million lives claimed each year. And CVD is the most common cause of death in both men and women.

“The statistics are staggering,” says Penny Heaton, M.D., Global Head, Office of the Chief Medical Officer, Johnson & Johnson. “We’re making progress, but the burden still remains enormous.” Nonetheless, Dr. Heaton is optimistic about advances in the field.

“We have what I call a ‘One J&J’ approach,” Dr. Heaton says. “We have two sectors working on CVD—Innovative Medicine and MedTech. Patients don’t come in with a little sign on their forehead that says, ‘I need drugs’ or ‘I need a device.’ We have experts who can study cardiovascular disease across the full patient journey, from its underlying biology to diagnosis, treatment and ongoing care.”

As a result, there have been breakthroughs like new and better medications to treat AFib and prevent stroke, and a pump for heart failure in patients who present with cardiac shock.

Better monitoring with new technologies is also closing the “gap between discovering the illness and being able to make a meaningful difference for the patients.” This is critical, says Dr. Heaton, since, “often by the time cardiovascular disease becomes clinically apparent, substantial damage has already occurred.”

The unique aspect of CVD, says Dr. Heaton, is that “while it’s global in scale, it’s also deeply personal. All of us can point to a parent, grandparent, spouse, friend or colleague whose life has been affected by it.”

At Johnson & Johnson, some of the innovators most closely tied to advances in the cardiovascular field have, like Dr. Chapman, an intimate connection to CVD that helps drive their work and their passion.

“The work is rigorous, highly technical and evidence-based,” Dr. Heaton says. “But the motivation behind it is deeply human. Having that personal connection feeds the sense of urgency and purpose, which helps strengthen the science.”

Read on for the stories of three Johnson & Johnson physician-scientists whose personal experience with heart disease and stroke inspires their work.

JoAnne Foody, M.D., Global Head, Cardiopulmonary R&D, Johnson & Johnson Innovative Medicine

Growing up in a family of pharmacists and healthcare providers, JoAnne Foody was primed to follow what she calls her North Star of being “someone who strives to make a difference in the world.” But she was also shaped by her family’s history of heart disease.

Dr. Foody saw that up close for the first time as a 10-year-old, when her grandfather, then in his 60s, suddenly became ashen while carrying chairs and umbrellas at the beach.

“He was diagnosed with inoperable heart disease, and at that time there weren’t a lot of good therapies available to him,” says Dr. Foody. “When he had a heart attack at the kitchen table about 15 years later, I wondered why we hadn’t known earlier about his blockages. It would have allowed him to make lifestyle changes sooner.”

In the years that followed, multiple other family members were diagnosed with CVD, including a grandmother who had AFib.

“There weren’t as many treatments or technologies at that time, so they managed her AFib with medications, including blood thinners, which she really disliked,” says Dr. Foody.

Ultimately, her grandmother succumbed to one of the dangerous side effects of early anticoagulants. In 2001, she had a fall that resulted in a devastating deadly bleed.

At that time, Dr. Foody was already well into her career in cardiovascular care, with a focus on prevention and public health.

After stints at Brigham and Women’s Hospital, the Cleveland Clinic and Yale University School of Medicine, she made a pivot into the pharmaceutical industry, working to develop cardiovascular medications.

“As much as I could make a difference individually with patients, we still had a lack of therapies to really improve patient outcomes,” Dr. Foody explains. “In pharma, I thought there was an opportunity to have a larger impact.”

Another key lesson from her years as a clinician: Very few of the interventions in cardiovascular medicine have been adequately studied in women.

At Johnson & Johnson, Dr. Foody has worked with researchers, academic institutions and the U.S. Food and Drug Administration (FDA) to change that, creating more inclusive clinical trials, including a current global study to test a new anticoagulant.

The innovations she has researched and overseen took on even more personal resonance when her mother was diagnosed with valve disease and AFib 15 years ago. Even though her mother’s heart disease was far worse than her grandmother’s, the advances in treatment options—ablations, pacemakers, anticoagulants—helped her mother, now 87, survive the disease she inherited.

“She is alive today because of all the advances in the field,” says Dr. Foody. “I want to make sure that someone else’s parents and grandparents are also there to see their great grandchildren, the weddings, the celebrations. It really isn’t about a job. It’s a personal passion.”

Dr. Foody’s pursuit of new options continues. Her grandmother’s experience reflects one of the biggest unresolved challenges in cardiovascular medicine: preventing stroke without creating an unacceptable risk of bleeding. Today, that challenge is central to Dr. Foody’s work exploring factor XIa (FXIa) inhibition, a potentially different approach to anticoagulation.

Roberta Chapman, M.D., Cardiologist and Vice President, Global Heart Failure, Heart Recovery, Johnson & Johnson MedTech

When Dr. Chapman received that distressing phone call from her mother, it was all the more surprising because her mother’s heart function had been thoroughly checked out a few years before—the first step on a long journey of missed signals and overlooked symptoms.

Her mother, then in her 70s, didn’t fit the stereotype of someone with heart failure. She was fit and active with a healthy weight; she didn’t smoke and drank only occasionally. Her high blood pressure had been dismissed as white-coat hypertension.

But then an echocardiogram showed marked hypertrophy of the left ventricle, a condition in which the wall of the heart’s main pumping chamber (the left ventricle) becomes thickened. In the absence of chest pain, she was put on medications.

Three years later, when Dr. Chapman’s mother did experience classic chest pain, she underwent catheterization, which showed blockages in all three major arteries. By then, much damage was done; she was too high-risk to undergo bypass or have a stent placed.

“She lived another 14 years with a pacemaker and various medications, but it really impacted her quality of life and ability to be active,” says Dr. Chapman. “It brought home that we don’t even have the clinical evidence to guide diagnosing and treating women.”

Her mother’s experience motivated Dr. Chapman to do more to increase participation of women in clinical trials.

“At Johnson & Johnson, we’ve now had three women serve as national principal investigators for our trials, while also bringing a broader range of physicians and patient perspectives into steering committees to help guide clinical trial design,” she says.

At Johnson & Johnson, she adds, “it is gratifying to know that I can help fill the gaps that led to the misdiagnosis in my mother. If the therapies we offer today had existed when she presented, she would have been a candidate for many of them.”

Today, Dr. Chapman’s work is part of the company’s broader commitment to addressing some of the biggest challenges clinicians face and some of the most life-altering conditions and issues patients experience, including cardiac arrhythmias, cardiovascular calcification, heart failure and stroke.

Alistair Lindsay, M.D., Global Head of Cardiovascular Development, Johnson & Johnson Innovative Medicine

More than two decades ago, Dr. Lindsay was on a cardiology fellowship in London when he received the text message that would change the trajectory of his career.

His 60-year-old mother in Scotland had been hospitalized following a stroke that left her paralyzed on one side of her body and unable to speak.

Originally from Glasgow, Dr. Lindsay—motivated by the high rates of CVD in western Scotland—had begun his medical training with the aim of becoming a practicing cardiologist.

But when he experienced firsthand the devastation stroke can bring to an entire family, he entered a three-year research program to better understand stroke and the unmet need around the disease.

Now, 15 years later, he oversees the development of potential new treatments for CVD at Johnson & Johnson, including a clinical development program exploring FXIa inhibition.

He views that career pivot “as the perfect marriage of my previous cardiology experience with what I had learned in my research—and what I experienced in my own family.”

Despite the common perception that strokes affect only older or unhealthy people, they can happen to anyone. Nearly four in 10 people hospitalized for stroke are, like Dr. Lindsay’s mother, under the age of 65.

Before her stroke, she worked as a chemistry and biology teacher and was part of a running club.

When she went to the hospital with chest pains, doctors noted undiagnosed AFib. “But it was only a brief episode of arrhythmia, so they sent her home with a plan for follow-up care,” Dr. Lindsay says.

Less than 48 hours later, the AFib recurred and caused a blood clot in her heart to travel to her brain, blocking blood flow and resulting in an ischemic stroke.

She was luckier than many, says Dr. Lindsay, in that she eventually became mobile and regained her speech, “but it was a very long and difficult road, especially in the first few years,” he says.

AFib and stroke are intimately connected. About 87% of all strokes are ischemic (caused by a piece of plaque or a blood clot), and one in five of those is associated with AFib.

“Stroke is the most common complication of AFib and about 60 million people worldwide have the condition,” says Dr. Lindsay. The work he is doing now is directly related to both.

“A secondary stroke is often even more debilitating,” notes Dr. Lindsay.

If different medication had been available to Dr. Lindsay’s mother, her case might have turned out very differently—a thought that is never far from his mind.

“Understanding how devastating stroke is on a family really pushed me to this challenge,” he says. “And beyond that, the socioeconomic burden of stroke is vastly underappreciated. Many people don’t have the recovery my mother did, and the long-term cost and burden for their families is enormous.”

Dr. Lindsay’s ultimate goal: a therapy that can stop all possible causes of stroke, and with a very low risk of bleeding. He feels it is within reach.

Learn more about Johnson & Johnson’s cardiovascular work in Innovative Medicine and MedTech.