Title: The independent and combined effects of exercise training and statin therapy in the primary prevention of cardiovascular disease
Funder: Health and Care Research Wales (Welsh Government)

Abstract: Cardiovascular disease (CVD) refers to any condition that affects the heart and/or blood vessels (e.g. heart attack, stroke) and is the leading cause of death and disability worldwide. In Wales, over 340,000 people are living with CVD and each year this causes 28% of all deaths. Physical inactivity is one of the biggest causes of CVD and Wales is currently the most physically inactive nation in the UK with one of the highest rates of CVD. Regular exercise and statin therapy are widely recommended to reduce CVD-risk. When prescribed after a heart attack or stroke, both exercise and statins reduce the risk of a CVD-related death by ~25%. However, far less is known about the relative effects of exercise and statin therapy in primary CVD prevention (i.e. before a CVD-event). Poor blood vessel function represents the earliest stage of CVD, which can be measured with ultrasound to sensitively detect early CVD-risk. Regular exercise provides a variety of cardiovascular benefits and has a direct therapeutic effect on blood vessel function. In contrast, statin therapy primarily reduces CVD-risk by lowering cholesterol, which may also improve blood vessel function. However, the independent effects of exercise training and statin therapy on blood vessel function have never been directly compared in the setting of primary prevention, and it’s currently unknown whether a combination of both interventions offers additional cardiovascular benefit. Therefore, the aim of the studentship is to conduct the first randomised controlled trial of the independent and combined effects of exercise training and statin therapy on blood vessel function in individuals at risk of CVD. This project will utilise cutting-edge ultrasound techniques to sensitively examine the respective cardiovascular benefit of these frontline strategies and provide healthcare practitioners with novel insight into the most effective and personalised preventive treatment options to reduce CVD-risk in Wales.

Lay abstract: Cardiovascular disease (CVD) refers to any condition that affects the heart and/or blood vessels (e.g. heart attack, stroke) and is the leading cause of death and disability worldwide. In Wales, over 340,000 people are living with CVD and each year this causes 28% of all deaths. Physical inactivity is one of the biggest causes of CVD and Wales is currently the most physically inactive nation in the UK with one of the highest rates of CVD. Regular exercise and statin therapy are widely recommended to reduce CVD-risk. When prescribed after a heart attack or stroke, both exercise and statins reduce the risk of a CVD-related death by ~25%. However, far less is known about the relative effects of exercise and statin therapy in primary CVD prevention (i.e. before a CVD-event). Poor blood vessel function represents the earliest stage of CVD, which can be measured with ultrasound to sensitively detect early CVD-risk. Regular exercise provides a variety of cardiovascular benefits and has a direct therapeutic effect on blood vessel function. In contrast, statin therapy primarily reduces CVD-risk by lowering cholesterol, which may also improve blood vessel function. However, the independent effects of exercise training and statin therapy on blood vessel function have never been directly compared in the setting of primary prevention, and it’s currently unknown whether a combination of both interventions offers additional cardiovascular benefit. Therefore, the aim of the studentship is to conduct the first randomised controlled trial of the independent and combined effects of exercise training and statin therapy on blood vessel function in individuals at risk of CVD. This project will utilise cutting-edge ultrasound techniques to sensitively examine the respective cardiovascular benefit of these frontline strategies and provide healthcare practitioners with novel insight into the most effective and personalised preventive treatment options to reduce CVD-risk in Wales.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;3.3 NUTRITION AND CHEMOPREVENTION
Health categories: CARDIOVASCULAR