With a growing need to better understand the many links between heart disease and cancer, the two leading causes of death worldwide, the American Heart Association announced today grants focused on this area of scientific research. More than $11 million in research grants are awarded to four multidisciplinary teams to create the Association’s newest Strategically Focused Research Network on disparities in cardio-oncology. Specifically, these teams will develop breakthrough solutions to better identify and address how the combination of these diseases disproportionately affects underrepresented populations. Research teams at the Medical College of Georgia at Augusta University, Boston University School of Medicine, the Medical College of Wisconsin and the University of Pennsylvania will receive more than $2.7 million each for their individual projects aimed at reducing critical deficiencies related to disparities in cardio-oncology and increasing the understanding of the causes, consequences, treatment and prevention of cardiovascular disease among cancer patients and cancer survivors from diverse populations. “While the evolution of new therapies has improved the prognosis of many cancer patients, we’ve seen new challenges emerge as the very treatments that can cure people of cancer can also lead to short- and long-term cardiovascular complications,” said American Heart Association volunteer Dr. Kristin Newby, a professor of medicine at Duke University School of Medicine and chair of the Association’s peer review team for the selection of the new grant recipients. “There were more than 17 million cancer survivors in the U.S. in 2020, representing about 5% of the country’s population. Thus, the field of cardio-oncology has emerged as a critical new research area to address these concerns, as well as those related to findings that cancer itself can lead to cardiac disease, and the growing data suggesting that CVD and cancer share many common genetic, behavioral and environmental risk factors.” Newby noted the specific focus of the new research grants to study disparity solutions correlates to mounting evidence that health disparities often significantly contribute to poorer outcomes for people with CVD and/or cancer. Well-known drivers of disparities affecting health and health care include race/ethnicity, socioeconomic status, age, geography (e.g., rural vs. urban populations), language, gender, disability status, citizenship status and sexual identity and orientation. The projects, which commence on July 1, include:
- Cancer-Associated Thromboembolism as Affected by Health Disparities (CAT-HD) at Boston University School of Medicine Center – led by Katya Ravid, D.Sc., a professor of medicine, biochemistry and biology at Boston University School of Medicine, and Founding Director of the Evans Center for Interdisciplinary Biomedical Research and Office of Interdisciplinary Biomedical Research at Boston University, this team will use data from the Veteran Health Administration and Boston Medical Center to study the increased risk people with cancer have for developing venous thromboembolism (VTE), a blood clot that starts in the vein. Specifically, they will use multiple approaches to study which cancers are linked to the development of blood clots and what biological mechanisms cause the clots, as well as how health disparities, such as living conditions, diet and race influence blood clotting in people with cancer. This research may help to better predict which cancer patients are at risk for blood clots and to identify treatments to prevent blood clotting in some types of cancers. The Center will train post-doctoral fellows in this field of study, and will partner with Tougaloo College, a historically black liberal arts college in Jackson, Mississippi, to develop a training program linked to the center’s research mission.
- Obesity-Related Disparities in the Bidirectional Risk of Cardiovascular Disease and Cancer at the Medical College of Georgia at Augusta University in Augusta, Georgia – led by Neal L. Weintraub, M.D., a professor of medicine at the Medical College of Georgia at Augusta University, this team will study obesity, a common risk factor in people with cardiovascular disease and/or cancer. Specifically, the team’s population, clinical and basic science research will investigate obesity-related disparities among Black Americans who bear a greater burden of these diseases, seeking to understand why this population develops more problems with inflammation that contributes to heart disease and cancer. The center will serve as a platform for postdoctoral training, with an emphasis on underrepresented minorities. It will also partner with Paine College in Augusta, a historically Black college, to develop an undergraduate research internship for students who desire to pursue health care-related careers (clinical and research).
- Understanding and Addressing Disparities in Cancer Therapy Induced Inflammation and Associated Endothelial Dysfunction at the Medical College of Wisconsin in Milwaukee – led by Melinda Stolley, Ph.D., associate director of cancer prevention and control and a professor of medicine at the Medical College of Wisconsin, and by David D. Gutterman, M.D., senior associate director of the cardiovascular center and professor of medicine at the Medical College of Wisconsin, this team will study the effect of cancer treatment on blood vessels, which deliver treatment agents to the cancer and the heart. In collaboration with the University of Illinois at Chicago, the team will study Black and non-Hispanic white women with breast cancer in hopes of answering these questions: 1) How do breast cancer treatments affect blood vessel function in these two groups? 2) Can exercise prevent or lessen the vascular damage that contributes to the development of adverse cardiovascular events after breast cancer treatments and are there laboratory markers that predict cardiovascular damage from cancer therapy? and 3) Do personal, social or community factors affect the risk of heart damage? The team hopes to better understand how and why cardiovascular damage impacts women of color more than white women, and to determine if exercise can help reduce this disparity.
- Understanding and Reducing Racial Disparities in High-Risk Cardio-Oncology Communities at the University of Pennsylvania – led by Bonnie Ky, M.D., MSCE, an associate professor of cardio-oncology and director of the Penn Cardio-Oncology Translational Center of Excellence at the University of Pennsylvania, this team will focus on breast and prostate cancer, the most common cancers in women and men, making up almost half of cancer survivors today. They plan to use an evidence-based behavioral intervention of gamification combined with goal-setting strategies and social support to increase physical activity among high-risk breast and prostate cancer survivors and improve health in the community. Through basic and clinical research, they will also assess how a person’s genetic makeup, socioeconomic status and environment affect their heart health and determine whether these relationships differ according to race. They will build a training curriculum on race and disparities with a focus on building empathy, cultural humility and competency among trainees in cardiology and oncology. They will partner with Meharry Medical College in Nashville, Tennessee, to develop a medical student summer program.
“This new strategically focused research network supports the American Heart Association’s pledge to take immediate and ongoing action to accelerate social equity and improve health for everyone,” said Dr. Mitchell Elkind, president of the Association, professor of neurology and epidemiology at Vagelos College of Physicians and Surgeons and attending neurologist at New York-Presbyterian/Columbia University Irving Medical Center. “We are proud to support these exciting new scientific research projects and we look forward to their outcomes as we continue to combat the barriers to health created by structural racism.” With the launch of this new network, the American Heart Association has now invested more than $200 million to establish a total of 13 Strategically Focused Research Networks, providing an opportunity to address key strategic issues that were identified by the Association’s Board of Directors. Networks have already been selected to study prevention; hypertension; disparities; women’s health; heart failure; obesity; children; vascular disease; atrial fibrillation; arrhythmias/sudden cardiac death; cardiometabolic health/type 2 diabetes; and health technology. Each network centers around the understanding, prevention, diagnosis and treatment of the key research topic. Four to six research centers make up each network, bringing together investigators with expertise in basic, clinical and population/behavioral health science to find new ways to diagnose, treat and prevent heart disease and stroke. More Strategically Focused Research Networks will be forthcoming later in 2021 and beyond.