Tor 26 maj / År 40 / Nr 1 2022

Pressing issue of finding better ways to treat cardiovascular diseases – a global problem

The best way to solve tough scientific questions is to cross traditional disciplinary boundaries. The Sahlgrenska Academy at the University of Gothenburg has built up a strong foundation of research and knowledge related to cardiovascular diseases. The Gothenburg region is recognised globally for advanced expertise in this field, which has led to the formation of a Center of Excellence focusing on cardiovascular and metabolic research.

The Sahlgrenska Center for Cardiovascular and Metabolic Research (CMR) was founded in 2005, but this type of research has a long history at the Sahlgrenska Academy and the Institute of Medicine.

Most common causes of death
Around 100 people are currently working within the CMR, divided into 12 research groups. Defining the underlying mechanisms of the metabolic syndrome of insulin resistance and developing strategies to prevent and treat its life-threatening complications is the core aim of CMR researchers.

The metabolic syndrome is characterised by abdominal obesity, insulin resistance and high cholesterol levels. The number of individuals with this syndrome is increasing, and today one in four adults is affected by the syndrome. These individuals have a dramatically increased risk of developing type-2 diabetes and cardiovascular disease, thus making it a leading public health issue in high demand of better treatments and above all preventative treatments.
“We cover a very large scientific field and above all we are concerned with diseases that are among the most common causes of death in the world. Not only primarily targeting the western world as before, cardiovascular diseases are widespread all over the globe today. The need for further research is immediate”, Professor Jan Borén, Director at CMR, explains.

Examples from a broad area of research
Lena Karlsson is an active researcher at CMR, conducting a large national study in obesity. The Swedish Obesity Study, SOS, has gained international interest and is focusing on the advantages of bypass-surgery, targeting individuals who would benefit from this type of treatment.
By comparing the risks to the advantages, patients can be placed in different groups of those who would really benefit from surgery and those for whom it would present too great a risk compared to the actual gain.

Another study is concerned with the different types of fat and where the fat cells are located. When fat is stored in muscle tissue, the risks of developing type-2 diabetes increases, for example. Jan Borén continues:
“As we have access to more knowledge and better treatments today, more people survive heart attacks for example. However, the number of people affected by cardiovascular diseases is increasing and the treatments available cannot undo the damage that is already done, so to speak. We have to study the causes and understand the background in order to develop better treatments and medication”.

The impact on individuals and society at large
Cardiologist Annika Rosengren is conducting research close to her patients, as well as studying the impact of disease in society at large. In comparison, while Jan Borén is focusing on the mechanisms of the diseases and the causes, Annika is studying the often dramatic and rapid changes in the rates of cardiovascular diseases in society at large.
“The mortality rate in heart disease has decreased markedly, mostly thanks to better knowledge and changed behaviours, but also because of better medical treatment of patients with heart disease. This is, however, true only for the western world. The mortality rate is actually increasing in many middle- and low-income countries”, Annika Rosengren reveals. She continues:
“We are part of a global study involving three high-income countries and a number of low- and middle-income countries. The study is concerned with choice of food and the risks of developing cardiovascular diseases based on societal conditions and individual choices”.

The project is ongoing and is a long-term study of at least ten years, initiated almost ten years ago. The goal is to provide better insights on the causes of these diseases on a global scale and on treatments, not only those privileged to living in the western world.