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Cardiovascular Disease

The NIHR is the nation's largest funder of health and care research and provides the people, facilities and technology that enable research to thrive. We work in partnership with the NHS, universities, local government, other research funders (including industry and charities), patients and the public to improve the health and wealth of the nation.    

In 2017/18, the NIHR spent £17.7 million on research studies into cardiovascular disease through our research programmes. The NIHR Clinical Research Network (CRN) supported  465 studies on cardiovascular disease, 153 of which were new studies, and recruited 35,648 patients to studies last year (2018/19).

Speeding up access to vital clot-busting stroke therapies

Patients with acute ischemic stroke – caused by a blood clot in the brain – have a critically limited time to receive clot-busting (‘thrombolytic’) drugs if they are to avoid suffering  permanent brain damage. In dispersed rural environments, factors such as longer ambulance travel times to hospital add considerable complexity to local decisions around how to provide the best possible stroke care.

Researchers supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula have used advanced computational modelling to address the challenge of how to provide early thrombolysis to patients with acute ischemic stroke. The simulation provided information on improving patient care at virtually no cost, such as paramedics calling ahead to specialist stroke care units, allowing the units to prepare for the patient before the patient’s arrival.

A new solution for abnormally fast heart rate

An estimated 125,000 people in the UK are affected by supraventricular tachycardia (SVT) - a common heart rhythm disorder causing periods of abnormally fast heart rate. In emergency departments in the UK SVT is treated using the Valsalva manoeuvre, which involves breathing out moderately forcefully against resistance. Although safe, the success rate of the Valsalva manoeuvre is low (5-20%), and the alternative involves a dose of adenosine - an unpleasant experience that some patients report as a feeling of impending death.

A team funded by the NIHR Research for Patient Benefit (RfPB) Programme addressed whether a simple posture change - raising a patient’s legs - whilst delivering the Valsalva manoeuvre could increase the success rate.

The results of the REVERT study demonstrate a safe, cost-free and more effective way of treating SVT with just a simple change to current practice. The difference in success rate between the standard and modified manoeuvre resulted in a substantial reduction in the number of patients needing other emergency treatments, particularly adenosine.

Cardiovascular effects of lifelong exercise in veteran athletes

The Veteran Athlete's Heart is a cardiovascular research study set up with the support of the NIHR Clinical Research Network. The aim of the research was to study the cardiovascular effects of lifelong endurance exercise in the veteran athlete.

While there is little evidence to suggest that intense exercise in the first three decades of life harms individuals, research has found that veteran athletes’ show a higher prevalence of atrial fibrillation (an uncontrolled and irregular heartbeat) compared with sedentary individuals of a similar age. Small studies have also shown an increasing occurrence of myocardial fibrosis and atherosclerosis (a thickening of the heart valves) in these individuals.

The U-shaped curve, which shows the relationship between exercise intensity and adverse impacts on an otherwise normal heart. In short, moderate exercise is better than no exercise, but vigorous exercise may be harmful in some individuals.

Treating cholesterol with anacetrapib

The Randomized EValuation of the Effects of Anacetrapib through Lipid modification (REVEAL) trial is the largest study to have looked into the possible benefits of boosting good cholesterol and further lowering bad cholesterol to prevent heart attacks and strokes. The aim of the study was to discover if treating cholesterol with a new drug called anacetrapib (taken in combination with a statin) would drive down the risk of heart attacks, deaths from heart disease and other vascular diseases.

The results concluded that anacetrapib lowers the risk of heart attack and related cardiovascular complications among patients who are receiving intensive statin treatment. The NIHR Clinical Research Network helped to recruit participants from 63 sites across England exceeding its target by some 30 per cent in this international study.

Find a study in your area

You can find out more about research studies in your area through the Be Part of Research website.

There are more than seven million people in the United Kingdom living with cardiovascular disease, with over a quarter of all deaths a year resulting from the disease.

Cardiovascular disease research matters. It has meant:

  • improving clot-busting drugs to treat heart attack patients, increasing survival by 70 per cent
  • transforming treatments for cholesterol levels, significantly decreasing people's risk of heart disease
  • the discovery of genes linked to heart disease
  • better understanding of the mechanisms that can cause ‘sudden death’
  • supporting the trial of new medical devices to improve outcomes for patients

The NIHR Clinical Research Network (CRN) provides researchers with the practical support they need to make clinical studies happen in the NHS. This support covers every stage of research, from set up to delivery.

We provide world-class health service infrastructure - research support staff such as clinical research nurses, and research support services such as pharmacy, pathology and radiology - to support organisations seeking to conduct clinical research in the NHS in England. Some of this research is funded by the NIHR, but most of it is funded by NHS non-commercial partners and industry.

We support the set up and delivery of clinical research in the NHS through our Study Support Service and our Research Design Service helps researchers develop proposals to secure funding from our research programmes.

The Cardiovascular Disease Specialty is one of 31 specialties which bring together communities of clinical practice to provide national networks of research expertise and clinical leadership. It is made up of research-interested clinicians and practitioners who work at both national and local levels to ensure the studies that are included in our national portfolio of research are delivered successfully in the NHS.

National Cardiovascular Clinical Specialty Group

Each of our 15 Local Clinical Research Networks has at least one nominated local Clinical Specialty Research Lead for cardiovascular disease studies. These clinicians lead research groups to promote and support cardiovascular disease research within the NHS trusts in their area.

At a national level the local leads come together to manage the national cardiovascular disease research portfolio. This involves regularly reviewing the progress of studies, identifying barriers to recruitment, and coming up with solutions and strategies to help overcome those barriers. Our National Specialty Group of clinical experts offer advice and support to commercial and non-commercial customers looking to conduct research in the NHS.

Resources

Our Cardiovascular Disease Specialty profile gives an overview of our offer to the Life Sciences industry.

We work with the British Cardiovascular Society Clinical Study Groups and other professional bodies representing cardiovascular disease sub-specialties in the UK to define the research agenda, identify and support new clinical researchers and promote patient involvement in study design, delivery and recruitment.

British Heart Foundation, the UK’s major heart charity and largest independent funder of cardiovascular research, is represented on our specialty group.

Collaboration with other clinical specialties is integral to service delivery and research into cardiovascular disease. We work closely with other specialties, including Diabetes, Injuries and Emergencies, Renal Disorders, Stroke and Primary Care. This provides access to support and expertise which helps to maximise opportunities for recruitment of study participants.

Cardiovascular research is not only undertaken by cardiologists, but also by allied health professionals including paramedics and cardiac research nurses.

Collaboration with the Devolved Nations

Clinical research is being undertaken across the United Kingdom. We continue to work closely with the ScottishWelsh and Northern Irish clinical research networks to support the design and delivery of high quality research.

British Heart Foundation

Is the nation's heart charity and the largest independent funder of cardiovascular research. The NIHR works in partnership with BHF including the NIHR-BHF Cardiovascular Partnership.

Find out more about the British Heart Foundation

British Cardiovascular Society

Is the voice for all those working in the fields of cardiovascular care and research in the UK and aims to represent and support both the professionals who work in cardiology and the patients for whom we want to encourage the best possible treatment.

Find out more about the British Cardiovascular Society

The NIHR provides the support and facilities the NHS needs for first-class research by funding a range of infrastructure.

NIHR Biomedical Research Centres

NIHR Biomedical Research Centres (BRCs), partnerships between England’s leading NHS organisations and universities, conduct translational research to transform scientific breakthroughs into life-saving treatments for patients. The following BRCs undertake research in cardiovascular disease:

NIHR Medtech and In vitro diagnostics Co-operatives

NIHR Medtech and In vitro diagnostics Co-operatives (MICs) build expertise and capacity in the NHS to develop new medical technologies and provide evidence on commercially-supplied in vitro diagnostic tests. The following MICs undertake  research in cardiovascular disease:

NIHR-BHF Cardiovascular Partnership

This Partnership between the NIHR and the Bristish Heart Foundation (BHF)  is a combined network of world-leading researchers working to translate scientific discoveries into benefits for patients.

Find out more about the Partnership.

Work with our infrastructure

All of the NIHR facilities and centres are opening to working with the public, charities, industry and other partners. If you are interested in collaborating with the NIHR please contact the NIHR Office for Clinical Research infrastructure: nocri@nihr.ac.uk 

Our experts in the NIHR Clinical Research Network (National Specialty Leads) can give advice on delivering your cardiovascular disease study in the NHS.

Dr Paul Clift

Dr Paul Clift trained at Birmingham Children's Hospital, Great Ormond Street and the Heart Hospital in London, qualifying in 1993. He was a research fellow at the Royal Postgraduate Medical School, being awarded an MD in 2000 for his thesis on Endothelin and the Cardiovascular Response to Hypoxia.

He trained in Congenital Cardiology at the Heart Hospital in London and the Queen Elizabeth and Birmingham Children's Hospitals in Birmingham, before being appointed as a Consultant in Adult Congenital Heart Disease at the Queen Elizabeth Hospital in 2004.

Dr Clift is currently the NIHR Clinical Research Network National Specialty Lead for Cardiovascular Disease, specialising in pulmonary hypertension, congenital heart disease and arrhythmias. He has carried out varied research into congenital heart disease.

Dr Patrick Calvert

Dr Patrick Calvert is a Consultant Interventional Cardiologist at Papworth Hospital NHS Foundation Trust, specialising in coronary and structural intervention.

Dr Calvert graduated from the Universities of Cambridge and Oxford and trained in the Eastern Deanery for general and interventional cardiology, in both coronary and structural intervention. He undertook a PhD at Cambridge University, investigating vulnerability in coronary plaques using radio-frequency intravascular ultrasound and biomarkers, which resulted in several publications and prizes. Before undertaking a Fellowship in Paris in 2010 at Center Hospitalier Bichat with Profs Vahanian and Steg.

His programme of research into the vulnerable plaque continues with a multi-modality approach including VH-IVUS, OCT and PET-CT. He is Principal Investigator on several database projects examining the health outcomes from coronary and structural interventions using the BCIS database.

He is a member of the EuroPCR Programme Committee, TCT Scientific Committee in the US, as well as, a member of the Editorial Board of Advances in Interventional Cardiology. Dr Calvert is currently the NIHR Clinical Research Network National Specialty Lead for Cardiovascular, specialising in atherosclerosis and preventive cardiovascular diseases.

Prof John Pepper OBE

Prof John Pepper was appointed as a Professor of Cardiothoracic Surgery at the Brompton and Harefield hospitals in 1990. His clinical work spans across adult cardiac surgery, with a special interest in heart failure, mechanical circulatory support, aortic valve surgery and surgery of the thoracic aorta.

Prof Pepper has initiated ten randomised trials, all of which has resulted as papers in high impact journals. He is also the lead clinician for Aortic and Valve research for the Cardiovascular Biomedical Research Unit, and lead clinician for the Aortic theme in the Institute of Cardiovascular Medicine and Science (ICMS) between Brompton and Liverpool.

Since 2010, Prof Pepper has been chair of the Structural Heart Disease Care Group, at the Royal Brompton and Harefield NHS Foundation Trust. During this time the TAVI team has continued to grow and the UK TAVI trial recruiting to time and target.

Over the last eight years he has served on several trial steering committees and drug safety committees, working closely with the Imperial College Clinical Trials Unit. Prof Pepper is currently the NIHR Clinical Research Network National Specialty Lead for Cardiovascular Disease, with a special remit for heart failure and surgery.

Related Specialties

Diabetes

Stroke

Kidney Disorders

Surgery

Respiratory

Primary Care

Genomics and Rare diseases

Children

Critical Care

 

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