Research Report: One Brave Idea

Heart disease kills over 600,000 people in the United States every year, accounting for 1 in every 4 deaths. It is the leading cause of death for both men and women.

So, what is the medical community doing about it? Dr. Calum MacRae, the chief of Cardiovascular Medicine at Brigham and Women’s Hospital, is pursuing his “One Brave Idea” to solve this tremendous health crisis.

It all began when the American Heart Association, Verily, and AstraZeneca launched a crusade against cardiovascular disease. They came together to offer $75 million in funding, along with guidance, mentorship, and resources, to a researcher who could present an innovative, groundbreaking research initiative that would prevent or reverse coronary heart disease.

“We announced One Brave idea to disrupt the way that science is discovered, the way that teams of scientists come together, and the way that visions are created,” explained Nancy Brown, CEO of the American Heart Association, on the One Brave Idea website. “One thing we hope to accomplish is that by taking away the barrier of money, that we’re able to seed a very innovative team that comes from a number of different disciplines to bring their strengths together to find a cure for coronary heart disease.”

They called for research proposals, and Dr. MacRae answered.

The Idea

By identifying where heart disease begins, it can be stopped before it starts. Dr. MacRae’s “One Brave Idea” is a multi-phased research project that seeks to identify new risk factors for coronary heart disease. The researchers hope to develop a way for doctors to identify those at risk at a young age.

He described his One Brave Idea as “looking earlier at different parts of the body in a holistic way to try and understand how cardiac disease evolves.”

“There are subsets of [the] disease and you see patterns emerge time and time again. But, when you actually look at the tests, they always look roughly the same. The artery always looks like it’s blocked, the blood pressure always looks like it’s high, and the cholesterol always looks like it’s abnormal,” said Dr. MacRae, describing the inspiration behind his idea. “So, what I thought was, maybe if we looked much earlier, if we looked at new and different tests, we would be able to see [the] differences. That would then help us understand what is the difference in biology between each person.”

“We’re really looking at the very earliest stages of development because people have not really looked at how coronary disease affects the developmental biology. Everyone thinks of it as a disease you get when you’re in your 40s, 50s, and 60s,” he explained.
Dr. MacRae and his team will begin their research with a study “to collect genomic information, lifestyle data (sleep, activity, stress), key public health data (environmental and economic factors) and responses from people with CHD in their families,” according to the One Brave Idea’s website. This data will then be compared to data from the Framingham Heart Study and the Million Veterans Program.

Although Dr. MacRae only won One Brave Idea in October, he and his team are already hard at work. They’ve launched four initiatives so far and are using them to work out how their research system will work.

“The first thing we’re trying to do is to pick up earlier signs of risk for coronary artery disease. We already have two or three things we know that work,” he said. “We can measure things in the skin that actually detect cholesterol in the skin before it is abnormal in the blood.”

Utilizing Big Data

Dr. MacRae and his team are using the power of big data to pinpoint the exact moment when heart disease begins.
“It’s interesting. Everyone wants big data to succeed…What we’re trying to do is basically understand what parts of biology and medicine you could record in everybody, but could give information that we don’t already have. Instead of waiting for the information to show up, we’re going looking for it. It’s a proactive approach to big data,” Dr. MacRae said.
One example of big data that they’re analyzing is grocery lists. They are using this information to review the dietary habits of patients with coronary artery disease.

“We’ve already got access, in some populations, to shopping loyalty programs,” he explained.

The Challenges Ahead

Looking ahead Dr. MacRae is optimistic about his research but acknowledged that challenges may arise, as they do in all trials.

“I think the biggest challenge is trying to prioritize where to spend the money,” Dr. MacRae said. “What we need to do is spend the money wisely to reach the goals that we need to reach. $75 million sounds like a lot of money, but it’s probably not that much in the grand scheme of things. Thinking of how we can use the money to create more money and resources is also an important piece of this.”

Looking Forward

One Brave Idea will continue for at least the next five years and potentially beyond. The ultimate goal of the research project is to create preventative and pre-disease therapies to prevent heart disease from beginning.

If patients would like to join the fight against heart disease, Dr. MacRae encourages them to get involved with research.
“The best way for patients to get involved at the moment is through the American Heart Association’s My Research Legacy,” he explained. “It’s an online way of connecting with trials in the American Heart Association.”