AHA president: Multidisciplinary collaboration essential to tackling today’s issues
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Collaboration across disciplines and bridging connections between science and practice is imperative if today’s challenges — from COVID-19 to racial disparities — are to be resolved, according to the American Heart Association’s president.
During an address at the virtual AHA Scientific Sessions, Mitchell S.V. Elkind, MD, MS, FAAN, FAHA, professor of neurology and epidemiology at Columbia University Irving Medical Center, attending neurologist at NewYork-Presbyterian Hospital and the second neurologist to serve as AHA president, said today’s challenges “are perhaps the greatest in the history of the American Heart Association.”
CVD remains the “No. 1 killer in the world,” Elkind said. “Stroke, No. 2 globally, is also the leading cause of serious long-term disability. In addition, many people are affected by small infarcts deep within the brain, [which] are responsible for the slow decline in cognitive function seen in many of us as we age. This is effectively a form of brain failure, akin to heart failure. As a result, the idea that neurodegenerative diseases exist completely apart from vascular disease has been seriously challenged. Increasingly, evidence has been shown that vascular risk factors like hypertension, diabetes, obesity and atrial fibrillation are related to cognitive decline and dementia, in particular to Alzheimer’s disease.”
In cardiology, “we are beginning to cross the bridges that connect the cardiovascular and the neurodegenerative,” he said.
The AHA has started a collaboration with the Paul G. Allen Frontiers Group and other organizations to provide $43 million in funding for research of vascular and other age-related factors contributing to neurodegenerative diseases, Elkind said.
Such multidisciplinary work has helped advance the hypothesis that infections, including SARS-CoV-2, can cause neurovascular disease, he said.
“SARS-CoV-2 encourages us to build even more bridges among infectious disease, cardiovascular disease and cerebrovascular illness,” he said. “To consider our special fields separated by barriers is as unwarranted as the false dichotomy between education and practice that [philosopher John] Dewey criticized. The greatest intellectual discoveries occur in the intersections between fields.”
There are parallels between today’s world and 100 years ago when the AHA was formed, as a century ago countries were ravaged by rheumatic heart disease, caused by an infection, and today they are ravaged by COVID-19, Elkind said.
“This pandemic has reminded us that to improve health, we must also improve social conditions,” he said. “The disparities and inequities made manifest by the pandemic were clear before the virus struck. The AHA has worked to address the social determinants of health, because your ZIP code should not determine how long or how well you live.”
As a result, the AHA in 2018 began investing in community-based solutions to reduce social and economic barriers to health equity and has funded 33 social entrepreneurs toward that end, according to Elkind.
The AHA now plans to take actions to end structural racism and its impact on health, in accordance with its recently issued presidential advisory, he said.
“In an era of expanding globalization and worldwide travel, we nevertheless lack sufficient communication and cooperation,” he said.
Each of us have to imagine that our specialized area of knowledge coexists with other areas, “producing a more coherent, purposeful whole,” Elkind said. “To improve cardiovascular health, we have many bridges to build among medical disciplines, and others we need to strengthen, like the links connecting the scientific and medical community to our leaders and the public, and those among all countries.”
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Elkind MSV. Presidential session. Presented at: American Heart Association Scientific Sessions; Nov. 13-17, 2020 (virtual meeting).
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