Eight thousand Spanish men and women over 20 years of age will have ultrasounds of their femoral (in the groin) and carotid (in the neck) arteries as part of the REACT research project, which will study how cardiovascular diseases begin in young adults. The objective of the project, financed with 23 million euros by the Novo Nordisk Foundation and led in Spain by the National Center for Cardiovascular Research (CNIC), is to change the strategy for preventing strokes and heart attacks.

“At this time we treat risk factors such as hypertension or excess cholesterol. But we have discovered that cardiovascular disease begins before these treatments are administered. We think that we must treat those who have the disease, instead of basing ourselves on risk factors. We want to change the paradigm,” declares Borja Ibáñez, scientific director of the CNIC and coordinator of the REACT project in Spain.

Another CNIC investigation, the PESA project directed by cardiologist Valentín Fuster, revealed that approximately two-thirds of adults between 40 and 55 years of age have undiagnosed atherosclerosis, with abnormal accumulations of cholesterol in the arteries. When the latest PESA results were presented last December, some cardiologists already advocated improving early detection and starting treatment earlier.

The Novo Nordisk Foundation – the philanthropic foundation with the largest budget in the world – contacted the CNIC two years ago to design a transformative proposal on cardiovascular prevention, reports Borja Ibáñez. The approved proposal, announced today, is an eight-year project that will be co-led by the CNIC in Spain and the Copenhagen University Hospital (Rigshospitalet) in Denmark, home country of the Novo Nordisk Foundation.

For the first two and a half years, until the end of 2026, an investment of 23 million euros is planned, which will allow 8,000 people to study in Spain and the same number in Denmark. The participants, half men and half women, and between 20 and 70 years old, will have ultrasounds of their carotid and femoral arteries, which will reveal whether they have atherosclerosis and what volume. Half of them will also undergo coronary artery angiography to evaluate the relationship between the state of the heart arteries and peripheral arteries.

If atherosclerosis is detected, participants will be helped to adopt healthier habits, including dietary and physical activity recommendations. In cases where it is considered appropriate, these recommendations will be complemented with medication, for example, against hypertension or excess cholesterol.

“We do not want to have the entire population under treatment for life,” warns Borja Ibáñez, who is also a cardiologist at the Fundación Jiménez Díaz hospital in Madrid. “Our hypothesis is that a period of treatment may be enough for the disease to remit. Instead of increasing the volume of the treated population, it could even be reduced.”

This hypothesis emerges from the results of the PESA study, in which more than 4,000 Banco Santander workers participated, which revealed that atherosclerosis is not an irreversible progressive disease as believed, but that there are people in whom it remits. But the chances of remission are higher in young, non-smoking people without high cholesterol levels. Hence the idea that the disease can be cured if it is detected early, but will require chronic treatment if it is detected when it is already advanced.

The continuation of the REACT project until 2032, with an additional investment from the Novo Nordisk Foundation that has not yet been announced, will allow long-term follow-up of the participants and check whether, as researchers hope, early detection leads to a cure for the disease. cardiovascular.