Chances are you probably have the basics down when it comes to protecting your heart: You get your cholesterol and blood pressure checked regularly, and have those numbers memorized. And maybe you’ve made some lifestyle changes, such as exercising more and limiting trans fats.
But even as people are getting savvier about heart health, there’s much that we—and researchers—still need to learn about cardiovascular disease. Despite advancements in public awareness, prevention and care over the last few decades, it remains the leading cause of death for both men and women in the United States.
“We still have a way to go in addressing the underlying causes of coronary disease and heart failure,” says cardiothoracic surgeon Charles R. Bridges, M.D., Sc.D., Global Chief Technology Officer, Pulmonary Hypertension Therapeutic Area, R&D, part of the Janssen Pharmaceutical Companies of Johnson & Johnson. “But it’s an exciting time because we’re seeing rapid advancements in novel therapies, such as gene editing and biotechnology, that will inevitably lead to new and better treatments.”
Since November is Pulmonary Hypertension Awareness Month, we asked Dr. Bridges to tell us more about these exciting new areas of cardiac research—as well as share some lesser-known facts about heart health that could help keep your ticker in top shape.
1.
Just a small amount of exercise can really benefit your heart.
Physical activity is extremely important in reducing cardiovascular disease risk. However, carving out an hour a day to do moderate-intensity exercise—which some recent studies recommend—can seem intimidating. But when it comes to protecting your heart, even short periods of activity can go a long way.
“Exercising for just 20 minutes three times a week has been shown to decrease the risk of heart disease dramatically,” Dr. Bridges says. “That’s certainly better than nothing, and it’s a lot easier for people [to manage]. But I don’t think this message is getting out there.”
And while aerobic exercise—walking, running, swimming, biking—is considered best for the heart, it turns out strength training may offer protection as well. A recent study published in Medicine & Science in Sports & Exercise suggests that lifting weights for less than an hour a week may reduce a person’s risk of heart attack or stroke by 40 to 70%.
2.
Some types of hypertension are more dangerous than others.
High blood pressure is always a serious concern: It’s a major risk factor for heart failure, coronary artery disease, stroke and more.
But for those with pulmonary arterial hypertension (PAH), a form of high blood pressure that affects the arteries in the lungs and the right side of the heart, the consequences can be more immediately grave. As the arteries and capillaries narrow and become blocked, the right ventricle has to work harder to pump blood into the lungs, causing it to become weakened and enlarged in just a few years. This may result in heart failure and eventually death.
Fortunately, PAH, which is more prevalent in women and can occur at all ages but most frequently impacts those in their 40s, is rare. But because it’s so uncommon, it’s often hard to diagnose, Dr. Bridges says.
“If you go to the doctor complaining of symptoms of PAH, such as shortness of breath, fatigue and dizziness, your doctor is more likely to suspect a condition that causes similar symptoms, like asthma, COPD or atrial fibrillation—all of which are much more common than PAH,” Dr. Bridges explains. “Many people go to two or three different cardiologists or pulmonologists before they’re properly diagnosed.” As a result, he adds, those with PAH experience a delay in diagnosis of about three years.
The good news is that this is starting to change as doctors become more aware of the condition. Plus, the delay in diagnosis may continue to shrink with the development of new, less-invasive tests for PAH—something Johnson & Johnson is deeply committed to accomplishing.
Currently, the condition can only be definitively identified through an inpatient diagnostic workup called right heart catheterization, which involves threading a catheter through the neck or groin to reach the heart and pulmonary arteries. To innovate other options, Johnson & Johnson has “partnered with a number of companies to investigate blood-based biomarkers for the disease, as well as breath-based tests,” Dr. Bridges says. “There are volatile organic compounds in the breath that can help distinguish a number of different lung conditions, and PAH may be one of them.”
In many cases, people with atrial fibrillation experience such symptoms as palpitations, fatigue, shortness of breath, malaise, dizziness, anxiety and chest pain. But 15 to 30% of patients don’t have any symptoms, so they have no idea they even have the potentially life-threatening condition.
3.
You could have atrial fibrillation and not know it.
In many cases, people with atrial fibrillation (AFib)—an irregular and often rapid heartbeat that increases the risk of stroke and heart disease—experience such symptoms as palpitations, fatigue, shortness of breath, malaise, dizziness, anxiety and chest pain. But 15 to 30% of patients don’t have any symptoms, so they have no idea they even have the potentially life-threatening condition.
“Unfortunately, many people don’t even know what atrial fibrillation is and how devastating it can be,” Dr. Bridges says. “It increases the risk of stroke and heart attack, and over time, can lead to heart failure.”
To complicate matters, AFib may not be picked up during a physical exam or even during an ECG. “People may be in AFib only 10% of the time, so there’s a 90% chance their doctor wouldn’t detect the condition at any given time,” he explains.
One way to help address these challenges is to explore new methods for detecting AFib. Dr. Bridges notes that smartwatches with heart rate sensors have helped contribute to greater public awareness simply because they collect data on irregular heart rhythms over an extended period of time.
In January, Johnson & Johnson announced a collaboration with Apple to investigate whether using a heart health app, in combination with the Apple Watch with ECG, can help accelerate the diagnosis of AFib and improve health outcomes.
And recently, Johnson & Johnson named one such innovation, FibriCheck, the winner of its Johnson & Johnson Innovation, JLABS Mobile Wellness Management Challenge. The medically certified screening and monitoring app allows users to place a finger on their smartphone’s camera to measure their cardiac rhythm. The data is then automatically sent to a medical professional in order to get a faster diagnosis. FibriCheck expects to bring the product to the U.S. market sometime this year.
4.
Exciting advances are on the horizon that could reshape cardiac care.
Heart rhythm monitor apps and advances in PAH diagnostics are just the beginning.
Another project in the works: a predictive, machine-learned algorithm that uses a new, noninvasive form of medical imaging that’s in development at JLABS @ Toronto, part of Johnson & Johnson Innovation’s network of healthcare incubators. It has the potential to assist physicians in diagnosing and treating heart conditions like coronary artery disease—a process that currently can take weeks—helping make the process easier and more efficient.
“The company, Analytics 4 Life, is working on a new radiation- and exercise-free cardiac imaging test that so far has shown results that compare favorably to nuclear stress testing for the diagnosis of coronary artery disease,” Dr. Bridges says.
Recently, Johnson & Johnson announced a collaboration with Analytics 4 Life to also develop algorithms for the noninvasive detection of pulmonary hypertension to help with earlier diagnosis and improved outcomes. This test can be administered and reviewed by a physician within a single office visit—results are available on a web portal just minutes after the test is completed.
And thanks to the acquisition of Swiss biotechnology firm Actelion in 2017, Johnson & Johnson is now in a position to also help advance care for patients with PAH. “Actelion leads the market in PAH treatments,” Dr. Bridges says, “and we’re now looking at new ways to help improve symptoms and potentially even reverse the disease.”
And as AFib becomes more common—at least 33.5 million people globally are currently living with the condition, and the epidemic is expected to double in prevalence by 2030—the need for new treatments is crucial.
Biosense Webster, part of Johnson & Johnson Medical Devices Companies and a global leader in the science of diagnosing and treating heart rhythm disorders, has made great strides in catheter ablation therapy for AFib. During the procedure, doctors are able to correct the arrhythmia by safely scarring tissue inside the heart. Last year, Biosense Webster treated the first patient with an innovative catheter designed with contact force sensing, temperature sensing and microelectrode technology—advances that could result in shorter and more efficient procedure times.
“With catheter ablation therapy as a long-term strategy to control heart rhythm, some patients may be able to avoid a lifetime of anti-arrhythmic drugs or anticoagulants, which may come with unwanted side effects and a risk of bleeding,” Dr. Bridges says. “It has been proven to improve life expectancy and quality of life, so patients can enjoy interests that AFib may have taken away from them.”
