Copy of Combating cardiovascular disease from the age of 20: the ambitious goal of the international project led by the CNIC

CNIC

Cardiovascular diseases are silent. They can develop over decades without showing their face , without symptoms that would suggest a problem.

This is what happens, for example, with atherosclerosis, the accumulation of cholesterol plaques and other substances inside the arteries that, over time, can cause their obstruction and trigger serious disorders, such as heart attacks. In many patients, this disorder develops progressively over decades without causing symptoms until the problem becomes serious.

A team of Spanish and Danish researchers led by the National Centre for Cardiovascular Research (CNIC) wants to change this reality and transform cardiovascular prevention by detecting atherosclerosis early .

The project, called REACT, will be developed at the CNIC and at a hospital in Denmark, specifically the Rigshospitalet in Copenhagen.

"REACT aims to change cardiovascular prevention protocols by detecting atherosclerosis through imaging screening from a very early age, from age 20, and a personalized intervention based on the presence or absence of silent disease," explains Borja Ibáñez, scientific director of the CNIC, cardiologist at the Fundación Jiménez Díaz hospital in Madrid and leader of the project.

"We know that atherosclerosis can progress silently for more than three decades. But imaging tests could detect it early , which would allow interventions to be carried out to prevent its progression and the onset of the disease," says Ibáñez.

As he explains, the accumulation in the arteries generally begins in places such as the legs and neck, in the femoral and carotid arteries , before also spreading to the coronary arteries , the arteries that supply blood to the heart.

The program therefore aims to perform imaging tests in these areas of the body, in addition to blood and genetic biomarker analysis, to perform accurate screening for atherosclerosis that allows for early detection .

The REACT project is expected to last eight years, divided into two phases with an intermediate evaluation. In its first phase, REACT will include 16,000 people, 8,000 from each country, whose ages will vary between 20 and 70 years. In the case of Spain, a large part of the 8,000 people included in the study will be recruited thanks to the collaboration between the CNIC and Banco Santander, which have already carried out various cardiovascular prevention projects.

For the first phase, which will last two and a half years, funding of 23 million euros has been provided by the non-profit Novo Nordisk Foundation.

According to Ibáñez, the second phase of the project will aim to develop strategies to prevent the progression of atherosclerosis in cases where it is detected early and to reduce the risk of cardiovascular disease.

"We want to change the guidelines and protocols for cardiovascular prevention and implement personalized and precise interventions based on the individual's condition," says the cardiologist, who emphasizes that this preventive approach would reduce both the burden of cardiovascular disease and the years of treatment currently used to keep it under control.

The project also aims to develop risk calculators to assess, in the general population, those people most likely to develop atherosclerosis early, in order to screen them early and be able to intervene quickly.

This project, according to the CNIC, has its roots in the PESA-CNIC-Santander project, led by Valentín Fuster, director general of the Centro Nacional de Investigaciones Cardiovasculares (CNIC), president of Mount Sinai Heart and Medical Director of the Mount Sinai Hospital in New York, who is also directly involved in REACT. "The PESA project has taught us that atherosclerotic disease begins at a very young age and that if an early intervention is carried out on it, it is possible not only to prevent its progression, but also to cure the disease," Fuster said in a statement.

This project is part of the "new mechanisms of atherosclerosis" program, initiated at CNIC within the framework of the Severo Ochoa 2020 project.