Thousands of volunteers are hunted for an experiment that goals to avoid wasting tens of millions of lives | Science | EUROtoday

The most well-known volunteer wished advert on the planet probably by no means existed. “Men are wanted for a dangerous journey. Low wages, extreme cold, long months of complete darkness. Safe return doubtful. Honor and recognition in case of success,” revealed the polar explorer Ernest Shackleton within the London press in 1914, in line with legend, earlier than embarking on a visit to Antarctica. Cardiologists Borja Ibáñez and Valentín Fuster, from the National Center for Cardiovascular Research (CNIC), at the moment are making a much less epic, however extra transcendental name: they’re in search of 8,000 volunteers to attempt to discover “the cure for atherosclerosis”, the buildup of fat and ldl cholesterol within the arteries that may trigger deadly mind or coronary heart assaults. The results of his experiment can save tens of millions of lives.

Ibáñez particulars the essential circumstances to take part: being between 18 and 69 years outdated and never being conscious of affected by any heart problems. A journalist from EL PAÍS – 46 years outdated, 176 centimeters tall and 85 kilos – volunteers. The CNIC staff in Madrid performs free two-hour medical checks that will value hundreds of euros: a three-dimensional ultrasound of his carotid arteries (within the neck) and femoral arteries (within the groin), a scan of his coronary heart, an electrocardiogram, a blood and urine evaluation, images of the fundus of the attention to evaluate the blood vessels of the retina. Sonographer Virgina Mass utters a lapidary phrase as she slides her probe alongside the volunteer’s neck: “The important thing is the internal carotid, which goes directly to the brain.”

Atherosclerosis is a ubiquitous however invisible downside. Six out of ten apparently wholesome individuals, between 40 and 55 years outdated, have already got indicators of the illness of their arteries, as revealed by a earlier CNIC research with 4,000 Banco Santander employees. “Cholesterol is the basis of 70% of all cardiovascular diseases. And cardiovascular diseases are the main cause of death in the world,” warns Ibáñez. Every 12 months they kill 20 million individuals.

The newest check within the new trial is a really subtle method that makes use of X-rays to acquire a transparent picture of the within of the center’s arteries: computed tomography angiography. The participant receives a sprayed dose of nitroglycerin beneath the tongue, to dilate these coronary vessels. “Don’t worry, it’s not going to explode,” jokes heart specialist Carlos Pérez, on the mouth of the tunnel of the machine into which the volunteer is inserted. Nurse Pilar Hernández injects 60 milliliters of a innocent iodine-based dye into his veins. The aspect impact is placing. “You will feel genital heat, but it is totally temporary,” warns the physician.

The check outcomes arrive two weeks later. The ultrasound reveals the existence of a plaque of about six cubic millimeters of fats and ldl cholesterol within the left carotid artery, not giant sufficient to impede blood move to the mind, however disturbing. The CT angiography report reveals two extra plaques within the coronary heart arteries, one among them inflicting a slight narrowing.

Borja Ibáñez himself explains the outcomes to the volunteer. “There is nothing alarming, you are the paradigm of this clinical trial,” he assures. With a 46-year-old individual with three plaques and no signs, the conventional factor could be to do nothing, however the CNIC staff proposes the alternative: an aggressive and early intervention, primarily based on sport and a nutritious diet, but additionally on medication. Ibáñez prescribes the volunteer a every day pill of rosuvastatin, a patent-free treatment that prices about 20 cents and will increase the breakdown of unhealthy ldl cholesterol within the liver. “Your plaques are very small, but we have to prevent them from progressing. And, if they can disappear, let them disappear,” he says.

Ibáñez, born in Madrid 50 years in the past, is an fanatic of the British band Iron Maiden. On some events he has baptized his experiments with names impressed by this music group heavy metallichowever the brand new trial is just referred to as REACT: within the face of early indicators of atherosclerosis, you have to react (reactin English). “In the previous study with Banco Santander workers, we have seen that plaques like these or even larger ones disappeared after six years in 8% of the participants, precisely those who changed their lifestyle habits, lost a lot of weight, did a lot of exercise,” explains the heart specialist, scientific director of the CNIC. “We think that, with this more direct and aggressive approach, that 8% spontaneous can become 80%. If we manage to identify atherosclerosis early and cure 80%, the impact will be brutal. It is a disease that until now is considered chronic and irreversible, but we are convinced that we can cure it,” he proclaims.

The deployment of sources of the brand new trial is completely uncommon. The Novo Nordisk Foundation has offered 23 million euros to finance this primary part, carried out with 8,000 volunteers on the CNIC and one other 8,000 on the Kingdom of Copenhagen Hospital (Denmark). In Spain, some 5,300 individuals have already signed up because the experiment started final 12 months. Spanish cardiologists wish to have a consultant pattern of the inhabitants, so now they’re going to undertake an energetic seek for residents who don’t normally join scientific trials, reminiscent of residents of cities or residents of low-income working-class neighborhoods.

In the second part, between 2027 and 2032, individuals will likely be divided into two teams. In one among them, volunteers will obtain the remedy determined by their major care physician. In the opposite, the early and aggressive intervention proposed by the CNIC. This second stage will value about 40 million euros, which can even be offered by the Novo Nordisk Foundation, a Danish group that devoted 1.35 billion euros to financing scientific and environmental tasks final 12 months. The basis manages the fortune of Novo Nordisk, an organization based in 1923 that first received wealthy from the manufacturing of insulin and is now well-known for manufacturing Ozempic, the best-selling drug used in opposition to diabetes and weight problems.

Ibáñez imagines a future during which your complete inhabitants, from the age of 18, will endure a easy annual check-up, which is able to embody components reminiscent of measuring waist circumference. If the individual exceeds a threshold decided by a threat calculator, their carotid and femoral arteries will likely be analyzed with a easy transportable ultrasound machine. “As soon as it is identified that atherosclerosis is already developing, the risk factors must be intervened. If it is at age 20, at age 20. Our hypothesis is that five years of medication, early in life, can be equivalent to 35 years of medication much later,” he says.

Junk meals and a sedentary life-style, amongst different components, have triggered the variety of circumstances of cardiovascular ailments on this planet to double since 1990, going from 311 million individuals to 626 million. “Today we have the best treatments for all pathologies, but, paradoxically, cardiovascular diseases are increasing. What are we doing wrong?” asks the scientific director of the CNIC. “Well, we were doing all the primary prevention wrong before. When the clinical pathology occurs, we treat it very well, but if we have more and more patients, it is because we are doing it fatally. We must put all the focus on prevention,” he exhorts.

The heart specialist urges the authorities to be far more forceful in opposition to junk meals. “I would be ultra-aggressive. I would say to the big companies that sell this: Do you want to continue selling these processed things? Well, take taxes. You are going to finance healthy food with what you are selling unhealthy food. And the taxes, dedicated to subsidizing people’s consumption of olive oil, vegetables, fruit and so on.”