Associate feature: BHF's research has never been more important

COVID-19 is the biggest health care challenge we have faced in our lifetimes and learning how to tackle and mitigate the impact of it involves an unprecedented global effort. The role of the scientific community is vital.

We are learning more and more every day about this terrible virus, but the one thing we do know already is that it is having a devastating impact on people with heart and circulatory disease. The virus initially infects the respiratory system, but the most common underlying health conditions in those who die are cardiovascular. People with established heart disease are at higher risk of dying and the impact on people with cardiovascular risk factors such as diabetes is two to three times higher than the general population. Coronavirus has also been shown to damage the heart and blood vessels and increase the risk of blood clotting and inflammation which can lead to life-threatening deep vein thrombosis, heart attacks and strokes, even in people with no previous cardiovascular risk.

Here in Scotland, after dementia, coronary heart disease was the second most common pre-existing health condition recorded on death certificates for people who died with COVID-19 during May, according to data from National Records Scotland.

Supporting people with heart and circulatory diseases is the British Heart Foundation’s top priority and as the UK’s leading funder of independent research into cardiovascular disease, our researchers have joined the global fight against this pandemic.

Our team of world-leading BHF scientists, including those based here in Scotland at our Centres of Research Excellence in Edinburgh and Glasgow, and at universities across the nation, have been working tirelessly, collaborating with the rest of the BHF community in institutions around the UK and with others in the UK and abroad, to increase our understanding of the virus and identify new potential treatments.

We want to answer important questions that could lead to improved ways of treating and caring for people with COVID-19. We want to understand why people with heart and circulatory disease are at greater risk of death. We want to understand how the virus damages the heart and blood vessels, to find ways to prevent it. We are investigating the potential long-term complications of the virus on the heart and circulatory system to understand whether those who have recovered will need ongoing support and treatment. We want to determine whether medicines used to treat heart and circulatory diseases may affect the progression of the infection and identify new ways to protect people with COVID-19 from heart and circulatory complications or death.

We also want to better understand the impact of the pandemic on the normal care of people with heart and circulatory disease within the NHS. We know lockdown restrictions to protect the NHS and prevent the spread of the virus have impacted waiting lists with hospital treatments and tests postponed. The BHF therefore brought together research leaders from across the UK, through the existing NIHR-BHF Cardiovascular Partnership. Together, we developed a Framework to rapidly identify and prioritise the delivery of a small number of National Flagship Projects that address urgent clinical research questions on COVID-19 and cardiovascular health. Flagship status identifies projects that BHF and NIHR centres will support as a priority, while avoiding duplication of effort and maximising opportunities for added value. In the first three weeks of operation, the Framework received 13 research proposals for consideration. After rigorous peer review of each proposal, six have been selected as National Flagship Projects by the NIHR-BHF Cardiovascular Partnership. Each project involves multiple partners across the UK and will analyse very large clinical datasets. Collaboration is key and it has been truly inspiring to see the scientific community come together on such a scale and at such pace.

One of these projects is led by Professor Cathie Sudlow, Director of the BHF Data Science Centre and Professor of Neurology and Clinical Epidemiology at the University of Edinburgh. It will develop tools to link national hospital, primary care and mortality data with COVID-19 test data and with specialist cardiovascular healthcare datasets in a format that allows approved researchers within national trusted research environments to address the major unresolved issues about the relationship between COVID-19 and heart and circulatory disease.

Our BHF funded researchers are also involved in a number of projects under the Scottish Government’s Rapid Research programme.

A greater understanding of how COVID-19 affects the heart and circulatory system and the role it plays in disease severity may reveal key areas to help fight this devastating disease and ultimately save lives. But we need the public’s help to do this. We rely solely on their generous donations and every single penny is important to us.

Like many charities, the pandemic is having a significant impact on our work. In late March, all 750 BHF shops which raise vital funds for our research closed, including 76 in Scotland. Only now are we preparing to reopen in Scotland. Fundraising events have been either delayed or cancelled. In short, the means by which we raise money to fund research came to an abrupt standstill.

As a result, our income this year has been devastated, and this inevitably has a knock-on effect on the amount of research we fund. We estimate that our budget for investing in new research will halve this year from around £100m to around £50m – a sharp drop which could take years to recover to current levels. The same crippling challenges are being faced by research charities across the country.

But this crisis is about more than charity budgets – it imperils the future of research in the UK. The BHF currently supports a research portfolio of around £450m at 47 institutions across the UK, directly funding the salaries of more than 1,700 researchers and supporting the research of many others. If this funding is diminished, then it will have a profound effect on universities and research institutions across the UK, and ultimately risks slowing that crucial pipeline of research advances that in time will save lives across the world.

It would be a tragedy if we allowed the COVID-19 pandemic to threaten years of hard-fought progress in finding treatments and cures for some of the world’s biggest killers. We owe it to future generations of patients to keep funding research to find the next breakthroughs.

The BHF, along with the Association of Medical Research Charities and organisations including Cancer Research UK and Parkinson’s UK, is urging the UK Government to establish a Life Sciences-Charity Partnership Fund, where Government matches charity investment, so life saving research is protected through this toughest of times.

If the Government does choose to support medical research in this way, it will do much to preserve the UK’s reputation as a world leader in scientific innovation in the years to come. If charitable research funding becomes a casualty of the pandemic, it will leave our country diminished at a time when the need for research breakthroughs have never been more important.

Over the last six decades, our supporters have helped advance the prevention, diagnosis and treatment of many heart and circulatory diseases, helping save hundreds of thousands of lives. Our priority is to ensure this pandemic doesn’t change that.

Professor James Leiper BHF Associate Medical Director

This piece was sponsored by BHF