Heart health

Research is revealing the causes of heart disease and what can be done to tackle the world’s biggest killer.

Globally, 9 million people die each year from ischaemic heart disease. Despite falling rates of heart disease, tackling it is still a stubborn challenge.

Lifestyle is a major contributor to heart disease in adults, but risk factors such as genetics and parent lifestyle can also have an effect.

By accounting for the additive effect of multiple genetic variants, researchers can develop a system that improves their ability to identify the most vulnerable.

Anti-inflammatory therapies for cardiovascular disease are nearing the clinic. But whether scientists understand how inflammation contributes to fatty-deposit build-up well enough to target it effectively is open to debate.

A type of immune-cell priming called trained immunity is helping researchers to understand the disease mechanisms behind the build up of fatty deposits in arteries.

A high-fat diet is thought to increase the risk of a heart attack. But some say that the long-held dogma of ‘bad’ cholesterol might be flawed.

Coronavirus infections might cause lasting harm to the heart, even in those who have never had symptoms.

Researchers are debating how to convince the heart to heal itself instead of laying down scar tissue after a heart attack.

Heart-disease risk increases as women get older but explanations that centre on changes after menopause don’t tell the full story.

The notion that atherosclerosis can be prevented or mitigated by vaccination is now moving towards clinical trials. This strategy is based on the existence of autoimmunity to LDL, the cholesterol-carrying particles that accumulate in arteries. In this Comment, we discuss the underlying concepts, research basis and challenges for the development of a vaccine against atherosclerosis.

Extreme heat events are now more frequent in many parts of the world as a result of climate change. The combined effects of heat, air pollution, individual age, and socioeconomic and health status are responsible for avoidable acute events of cardiovascular disease and need to be considered in order to prevent and treat cardiovascular diseases effectively.

Social determinants of health in the African diaspora drive the lack of disease testing, increased prevalence of comorbid disease and reduced access to drugs, resulting in disproportionately higher COVID-19-related mortality among Black individuals than the rest of the population. We urge decisive attention to and action against ethnicity-based inequities that undermine cardiovascular health.

A genome-wide association study shows that myocardial trabeculae are an important determinant of cardiac performance in the adult heart, identifies conserved pathways that regulate structural complexity and reveals the influence of trabeculae on the susceptibility to cardiovascular disease.

Lymphatic endothelium secretes factors needed for heart growth and repair such as RELN, which helps with heart regeneration and cardioprotection after myocardial infarction.

Analysis of electrocardiograms using an end-to-end deep learning approach can detect and classify cardiac arrhythmia with high accuracy, similar to that of cardiologists.

Moderate exercise improves cardiovascular health and is associated with physiological cardiac adaptations; by contrast, the hearts of endurance athletes can undergo maladaptations, including myocardial fibrosis and arrhythmias. In this Review, Parry-Williams and Sharma discuss whether excessive endurance exercise might damage both diseased and otherwise normal hearts.

A strong relationship exists between exposure to air pollution and cardiovascular events. In this Review, Rajagopalan and colleagues summarize the evidence supporting the detrimental effects of air pollution on cardiovascular health and describe the potential mechanisms involved in air pollution-mediated cardiovascular mortality.

The beneficial effects of a Mediterranean diet on cardiometabolic health are associated with specific changes in the gut microbiome, suggesting a personalized approach towards cardiometabolic disease prevention.

Heart-forming organoids model early cardiac development.

Implantation of a perfusable device into the epicardium enables delivery of therapeutic agents and infiltration of reparative cells into the heart, amplifying the therapeutic effects of FGF-23 in a rat model of myocardial infarction.