A New Era of Cardiovascular Care

Insights from Dr. Joseph Wu

February 15, 2024 - by Rebecca Handler

A century ago, a diagnosis of heart disease was often a de facto death sentence. Fast forward to today, and the narrative has completely changed, thanks to monumental advancements in medical science and technology. At the vanguard of this transformation is Joseph Wu, MD, PhD, a pioneering figure whose work epitomizes the cutting-edge developments in cardiovascular care. 

As we observe American Heart Month this February, Wu—as director of the Stanford Cardiovascular Institute, professor of medicine and radiology at Stanford School of Medicine, and 2023-24 president of the American Heart Association—shares his insights into the current state of cardiovascular medicine and what the future might hold for treating and preventing heart disease.

The Current State of Cardiovascular Medicine

"The field of cardiovascular medicine today is incredibly exciting," Wu states, pointing to a slew of advancements that have significantly improved patient outcomes. "We've made leaps in interventional cardiology with stents, and in cardiac electrophysiology with the development of very small pacemakers. Open heart bypass surgeries and heart failure medications have also seen tremendous advances."

Among the most promising developments, Wu emphasizes the impact of new medications. "If I had to single out the most recent and promising advance, it would be medications like Wegovy and Ozempic.” Semaglutide, the active ingredient of these drugs, mimics the GLP-1 hormone, which is released in response to eating. This helps patients to feel full faster, and sequentially, to lose a significant amount of weight. “This significantly decreases cardiovascular mortality,"  Wu explains. 

The Future of Heart Disease Treatment and Prevention

Looking ahead, Wu is most excited about the potential for induced pluripotent stem cells (iPSCs) to revolutionize heart disease treatment. iPSCs can be generated from a patient's own cells, and have the remarkable ability to differentiate into a wide variety of cell types, including heart cells, under certain laboratory conditions.

Despite heart disease being the number one cause of death in the US, a recent survey shows that many are unaware of the risk factors. Improving public education and adopting simple lifestyle changes can significantly lower risk.

iPSCs also offer the tantalizing prospect of personalized heart disease treatments without the need for invasive procedures. Wu explains, "iPSCs represent a future where a tray of cells could predict the best treatment for your heart without a single incision or pill swallowed.". 

Normally, to find out if a new treatment is safe and works well, it has to go through rigorous testing, including experiments with animals and clinical trials with people, which takes significant time and money. But with iPSCs, scientists like Wu can conduct these tests in the lab using cells that act just like the ones in a human heart. This approach, which Wu refers to as "clinical trials in a dish," could dramatically streamline the development of new therapies by reducing reliance on traditional clinical trials.

Advancements in genetic medicine also hold enormous promise for the field of cardiology. Wu explains that we should expect to see,  within the next five to ten years, a future where genetic editing tools like CRISPR/Cas9 could be applied to correct mutations that lead to inherited heart diseases, such as familial hypercholesterolemia, which increase the likelihood of developing heart disease at an earlier age.

Life's Essential 8, American Health Association

Furthermore, Wu sees artificial intelligence (AI) playing a complementary role to physicians, enhancing diagnostic accuracy and efficiency. "Contrary to popular belief, AI won’t replace doctors. However, it can really help us facilitate our work load," he notes, envisioning AI's role in reducing burnout among healthcare providers. 

Challenges in the Field

A major challenge facing cardiovascular medicine is public awareness. "We need to do a better job educating our patients," Wu asserts. "Despite heart disease being the number one cause of death in the US, a recent survey shows that many are unaware of the risk factors. Improving public education and adopting simple lifestyle changes can significantly lower risk."

Wu shares that the American Heart Association's "Life's Essential 8" campaign is a step in the right direction, offering straightforward guidance on reducing heart disease risk through lifestyle changes to diet, sleep, activity, and more.

Reflecting on progress and future possibilities, visionaries like Wu highlight a key insight: medical progress hinges not just on new treatments and technologies but also on the commitment to understanding, preventing, and promoting awareness of heart disease. This comprehensive approach is our beacon of hope, promising a future where innovative research, public health efforts, and enhanced patient care revolutionize cardiovascular medicine.

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Joseph Wu, MD, PhD, provides invaluable advice on the different ways everyone can lower their risk for cardiovascular disease and help to raise public health awareness during American Heart Month and all year long.