Understanding the Role of Biopharmaceuticals in Cardiovascular Health
For National Heart Month, we explore the advancement of treatments for cardiovascular disease throughout history following new discoveries & breakthroughs in biopharmaceuticals.
What is Cardiovascular Disease?
Cardiovascular disease is an all-encompassing term for the various disorders of blood and heart vessels, which includes stroke, heart disease, heart attack, heart valve problems, arrhythmia, and heart failure. In some cases, individuals have a genetic predisposition for these disorders. However, there are a variety of risk factors that can increase someone’s likelihood of cardiovascular disease.
Some of these risk factors are environmental, such as air pollution, or they can be behavioral risks, such as a poor diet, lack of physical exercise, overconsumption of alcohol, or tobacco use. Professionals recommend strategies like reducing salt intake, consuming more vegetables and fruit, halting tobacco use, and regularly participating in physical activity to reduce risk.
The American Heart Association recommends getting 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic activity, or an equivalent combination, to maintain strong heart health.
Currently, the CDC reports that every 40 seconds, someone in the United States suffers from a heart attack. Cardiovascular disease is reported to be the leading cause of death for most ethnic and racial groups in the U.S, including Hispanics, African Americans, and non-Hispanic whites.
History of National Heart Month
Federally declared for the first time in 1964 by President Lyndon B. Johnson, National Heart Month is meant to bring awareness to heart disease, and educate on ways to prevent these deadly disorders. Many organizations such as the American Heart Association and the American Red Cross use this time to provide resources for people to further their education on cardiovascular disease, learn life-saving procedures like CPR, and discover new treatments for different cardiovascular ailments.
Brief History of Non-Pharmaceutical Treatment
The earliest documented evidence of a heart attack - caused by a plaque build-up called coronary atherosclerosis - was in 1550 B.C. in an Egyptian princess. However, the turning point in recognizing the need for improved treatment was thought to occur in 1955, with the passing of then President Dwight D. Eisenhower from a heart attack. Following this event, the public became more aware of the limited treatment options available for heart attacks at the time.
Shortly after, the first coronary care unit opened in Kansas at the Bethany Hospital, which was an area with specialized staff and equipment for cardiovascular care. A key piece of equipment in this unit was the world’s first portable defibrillator, used to deliver an electrical shock to restore a normal heart rhythm in individuals experiencing sudden cardiac arrest.
In 1981, Dr. Melvin Scheinman performed the first catheter ablation, which is used to treat atrial fibrillation. It involves guiding a tube from the groin into your heart in order to destroy any small areas of tissue that could be responsible for causing an abnormal heartbeat. Catheter ablation is performed by an electrophysiologist who is specially trained. This treatment is still used today when an individual suffering from arrhythmias does not respond to medication.
The first successful mitral valve repair was performed by Dr. Elliot Cutler at Brigham and Women's Hospital in Boston in 1923, marking an early milestone in heart valve treatment. In the 1950s, Dr. John H. Gibbon, Jr., invented the heart-lung machine, making the first open-heart surgery possible. Other notable treatments in the 1960’s were the discovery of the Ross procedure by London heart surgeon Donald Ross, MD, the first mechanical mitral valve replacement, and donor grafts.
Pharmaceutical Approach to Cardiovascular Disease
In addition to the treatments mentioned above, researchers and scientists also worked to provide pharmaceutical solutions to cardiovascular ailments. One of the earliest examples was salicylic acid, which is the main active ingredient in what we now call aspirin.
Early use of salicin, which the body converts into salicylic acid, can be traced back to the ancient Egyptians, Greeks, and Romans who used willow bark as an antipyretic and painkiller. In 1763, Reverend Stone described the antipyretic effects of salicylates, which would be extracted for chemical synthesis by scientists in the 19th century. The first person to synthesize aspirin was Felix Hoffman, a Bayer chemist, in 1897.
Today, aspirin is commonly prescribed to individuals suffering from cardiovascular diseases like peripheral arterial disease, or who have previously suffered a heart attack or stroke. This daily prescription has the goal of thinning the blood, which reduces the risk of blood clots forming. A study done by the National Heart, Lung, and Blood Institute, reports that around 29 million adults aged 40 and older in the United States preventively take aspirin, even without having been diagnosed with heart disease.
Professionals debate the pros and cons of taking aspirin as a preventative measure for cardiovascular disease, and you should not start taking a daily dose of aspirin without discussing it with a trusted healthcare professional first. Additionally, this method is not recommended for individuals over the age of 70, as well as a few other risk groups that can be found on the American Heart Association's website.
Another example of biopharmaceutical innovation for heart disease is digitalis medicines, which are used to treat atrial arrhythmias (heart rhythm problems or irregularities) and congestive heart failure (CHF). It does so by increasing the amount of calcium in your heart’s cells, which in turn strengthens your heartbeat, increasing the blood flow throughout your body.
As an early treatment, digitalis medicine was discovered by botanist William Withering, who utilized the foxglove plant to treat dropsy (edema) in 1775. From there, the medicine was utilized for multiple medical applications, and is commonly known as digoxin currently. The National Institutes of Health (NIH) reports that 402 out of every 100,000 United States adults use digoxin.
Improving Treatment Through Discovery
Following the development of early treatments like aspirin and digoxin for cardiovascular disease treatment, there have been a plethora of biopharmaceutical discoveries for additional treatments. A few of these discoveries include statins and beta blockers.
The first statin - a class of drug that is used to lower an individual's cholesterol levels - was called lovastatin, and was approved by the FDA in the 1980’s. Lovastatin was a major breakthrough, as it produced one of the greatest reductions in LDL cholesterol levels at the time, without presenting many major side effects. It was originally developed by Merck Research Laboratories.
The treatment of high cholesterol is critical to cardiovascular health, as it has been proven to reduce risk of heart attacks, strokes, and other cardiovascular events. While Lovastatin had a lower incidence of side effects than comparable treatments, it was still associated with side effects, including liver complications and muscle pain.
Beta blockers are a class of medication that are used to protect the blood vessels, heart, and other organs from the effects of adrenaline (epinephrine) and noradrenaline (norepinephrine). The main effects of these medications are reducing heart rate and blood pressure.
Sir James Black was the first to introduce a beta blocker treatment in 1958, which, at the time, was used to reduce oxygen consumption during angina attacks. This discovery later earned Black the Nobel Prize in 1988. Beta blockers are now also used to treat high blood pressure, anxiety, and certain arrhythmias.
In addition to these treatments, many modern advancements have been made in cardiovascular treatment, including angiotensin receptor blockers (ARBs), mineralocorticoid receptor antagonists (MRAs), angiotensin-converting enzyme (ACE) inhibitors, and many more.
Celebrating National Heart Month at HPNE
Once again, #TeamHPNE is excited to participate in National Wear Red Day, part of the American Heart Association's Go Red for Women movement, which raises awareness about cardiovascular disease in women—their leading cause of death.
Disclaimer: This article is meant to serve as an informative piece, and should not be used as medical advice. For discussion on treatment, please contact a trusted healthcare advisor.
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About HPNE
As the industry needs grow, High Purity New England, Inc. continues to supply the biopharmaceutical industry with a range of innovative products, from drug discovery and development to fill-finish, including their flagship product, custom single-use assemblies, as well as pumps, sensors, bioreactor systems, storage and handling solutions and other single-use solutions. Along with their own manufactured products for the global market, they are also a distributor for more than 18 brands in North America.
