Rethinking heart disease
Cardiovascular disease is the leading cause of death in New Zealand and the leading source of adult disability.
University of Otago Wellington (UOW) researchers are advancing revolutionary approaches to understanding this area of medicine that explore our physical diversity – with potential to enhance diagnosis and treatment for tens of thousands of New Zealanders each year.
Leading the research is Dr Shieak Tzeng, director of UOW’s Centre for Translational Physiology. In collaboration with the International Research Network on Cerebral Hemodynamic Regulation, Tzeng’s team is challenging current understanding of how blood flow to the brain is regulated, so medical treatment of patients with brain blood flow-related problems can be individualised.
“It has become fashionable to talk about ‘individualised medicine’, but most scientists still apply reductionist approaches to this problem,” he explains.
“We are saying that reductionist data can bear little resemblance to what happens in a conscious living system where all processes are happening simultaneously. We want to explain why there is physiological diversity and we do that by understanding how different physiological systems integrate at a whole-organism level to achieve a function.”
For example, poor blood pressure control does not necessarily mean poor blood flow control. “Some people rely on different physiological mechanisms to maintain blood flow that we don’t routinely study or, until recently, didn’t know existed.”
The lack of variation in the way patients are managed, despite all patients being different, is a major clinical problem, he says. “Delving into people’s different physiological mechanisms for maintaining blood flow is absolutely key to achieving truly individualised care.”
Photo: Michael Roberts