Professor Bryan Williams: ‘Our Future Health will revolutionise cardiovascular disease prevention’
You’ve probably heard of the term ‘life span’ before. It refers to the number of years somebody lives for. But have you heard of the term ‘health span’?
Health span refers to the number of years a person is healthy for. Often, it is significantly shorter than life span.
“People are living longer, but lots of them are spending their later years unwell,” says Professor Bryan Williams, Chief Scientific and Medical Officer of the British Heart Foundation (BHF). “It’s putting a large burden on our health system.”
His words are backed by evidence. Research suggests that currently 54% of people aged 65 or older live with two or more serious health conditions. By 2035, that figure is expected to rise to 68%.
Yet many of those health conditions could have been prevented. And heart disease is a good example.
“Probably 85 per cent of heart disease and stroke can be prevented by changes in lifestyle,” says Bryan. Heart disease can begin in your body as early as your 20s, but you may not know until you have a heart attack or stroke in your 60s. If doctors can diagnose you at the start of your journey, they can help you avoid suffering from a major event that shortens your health span.
“Preventing diseases is like investing your money,” says Bryan. “The earlier you start, the better the returns.”
Prevention – for everyone
Earlier this year, the BHF decided to invest its own money in Our Future Health. The charity became one of our charity founding partners, taking a seat on our Founders Board alongside other partners who co-fund our programme. Bryan believes the decision will help to shape the future of cardiovascular research – and help the health system embrace disease prevention.
“Our Future Health will give us data and insights into the life course of disease,” he says. “It will show us the causes, developments and effects of cardiovascular disease – all at a scale that’s never been done before.”
The unprecedented depth of our data will help researchers to identify the people most at risk of heart disease. Importantly for Bryan, the data will span all areas of society, as our programme is designed to help everyone live longer and healthier lives.
“I grew up a working-class household in Liverpool,” he says. “I’ve lived and seen the impacts of social deprivation. Socio-economic status is the most powerful determinant of health outcomes. If you live in a poor part of the country, you have a shorter life expectancy and you live more years in poor health.” In other words, both your life span and health span are shorter.
“Our Future Health will help us to look into specific ethnic groups and socio-economic groups. Researchers will discover how our lifestyle interacts with our genetics.” That could mean finding new ways to predict who is at risk of heart disease, so doctors can offer preventative help before it’s too late.
Revolution not evolution
To make prevention the priority it needs to be, “the way we do medicine is going to have to change,” says Bryan.
“Having worked in the NHS for 40 years, I fully recognise that doctors are overloaded. I have a lot of sympathy for them. The system was never designed to deal with this many patients with this level of complexity. Medics are being told: ‘you’ve just got to do more’. But it’s not possible.
“However, we can’t keep trying to muddle on. It’s a false economy, because the challenge is only going to get greater. We’re going to have more people living with serious health conditions than ever before.”
“The only way we can deal with the challenge, is to transform the system,” he says. Bryan believes the preventative healthcare model will help to free up doctors in multiple ways. For example, AI and machine learning can analyse a patient’s risk of disease, helping doctors to move quicker to diagnosis and possible treatment.
Bryan adds that Our Future Health has already shown that much of the work of preventative healthcare – taking bloods, measuring blood pressure – doesn’t need the input of doctors.
“Our Future Health is giving our existing system a prod,” he says. “It’s shown that if you provide convenient appointments for people, they’ll attend. Currently, people can’t take a morning off work to go to their GP’s surgery to get their blood pressure checked – but they can visit a clinic in a supermarket car park, as part of their weekly shop.”
The healthcare of the future
So, what could healthcare look like in 20 years’ time, with the help of Our Future Health? Bryan sketches out his vision of prevention, across all diseases.
“The patient fills in a lifestyle questionnaire,” he begins. “They go to a convenient hub for tests: maybe urine, blood, blood pressure, heart rate and weight, an ECG, which are all done quickly in a semi-automated way.
“The system analyses the patient’s data using an algorithm based on research from Our Future Health. This gives them personalised recommendations. It might say: ‘you’re really fit and healthy, carry on doing what you’re doing.’ We’ll know the trajectories of disease for each type of person, so the system will automatically recall them for a check when needed. If the algorithm flags a problem, that’s when medical support will kick in.
“This isn’t about removing doctors or healthcare professionals from the system. It’s focusing medical resources where needed. And the algorithm will be constantly updated with new evidence, so it will get more and more accurate.
“Until now, patients have been like passengers in their healthcare. But when patients have information about their health, they can take responsibility for it.”
Bryan believes this new kind of preventative healthcare is more democratic. “Everybody will get the same high standard of interpretation of their data, and the opportunity to receive the best evidence-based medicine. That doesn’t happen in a pressurised healthcare system that’s reliant on individual doctors.
“It’s true that this is a utopian vision – but I think it can be done.”
Let’s prevent disease together
By volunteering for Our Future Health, you can help health researchers discover new ways to prevent, detect and treat common conditions such as diabetes, cancer, heart disease, stroke and Alzheimer’s.