Heart disease could be prevented before a patient is even born, research suggests.
In the UK alone, over 7 million people live with the condition, which is responsible for more than one in four deaths.
Studies have shown that low oxygen levels in the womb, one of the most common pregnancy complications, may put a baby at risk of cardiovascular disease in later life by damaging its heart and blood vessels.
This may come about as a result of pre-eclampsia, an infection of the placenta, gestational diabetes or maternal obesity.
Low oxygen can often be diagnosed while a woman is expecting if a scan reveals slow baby growth, however, treatment options are limited.
Scientists from the University of Cambridge have now found that giving pregnant sheep an antioxidant called MitoQ helped prevent heart disease at its very onset.
The team has stressed there is a “a long way to go” before the treatment may be offered to pregnant women, but added it could “completely change our way of thinking about heart disease”.
‘We need to think of prevention rather than cure’
“Many people may be predisposed to heart disease as adults because of the low level of oxygen they received in the womb,” said lead author Professor Dino Giussani.
“By providing a specific antioxidant supplement to mothers whose pregnancy is complicated by foetal hypoxia, we can potentially prevent this.”
Heart disease is said to set the UK back more than £30bn ($39bn) a year. The costs largely go towards treating the condition, rather than curing it.
There are increasing calls within the medical community to shift the focus of cardiovascular conditions from treatment to prevention.
“If we want to reduce the prevalence of cardiovascular disease, we need to think of prevention rather than a cure,” said Professor Giussani.
“Applying this concept to pregnancy complications, we can bring preventative medicine all the way back into the womb, it’s treatment before birth.
“It completely changes our way of thinking about heart disease.”
‘Very exciting’ development
Cardiovascular conditions are generally caused by an interaction between a patient’s genetics and their lifestyle habits, like overeating or smoking.
It is increasingly coming to light, however, that a foetus’ environment may predispose it to the disorder in later life.
Low oxygen in the womb, chronic foetal hypoxia, can bring about oxidative stress. This occurs when low oxygen causes damage to a developing foetus’ heart and blood vessels.
Oxidative stress largely originates in mitochondria, the energy powerhouses of a cell.
MitoQ – developed by the Cambridge scientists – selectively accumulates within mitochondria, working to reduce oxidative stress.
After establishing its safety, the team gave MitoQ to pregnant sheep that were exposed to low oxygen.
Sheep were chosen over laboratory rats or mice due to their cardiovascular development more closely resembling a human’s.
Results, published in the journal Science Advances, revealed the therapy protected against foetal growth restriction and high blood pressure when the offspring became adults.
In a second part of the experiment, the scientists used chicken embryos to uncover how MitoQ affects embryonic heart development, without being influenced by the foetus’ mother or the role of the placenta.
The results reinforced their theory that MitoQ protects against mitochondria-derived oxidative stress.
“It is very exciting to see the potential to use MitoQ to treat a baby during a problematic pregnancy and prevent problems arising far later in life,” said study author Professor Mike Murphy.
“There's still a long way to go before this can be used by pregnant mothers, but our work points to new possibilities for novel treatments.”
Professor James Leiper from the British Heart Foundation – which funded the research – added the results suggest a “plausible way to reduce the future risk of high blood pressure and consequent heart disease in babies from complicated pregnancies”.
“Further research is now needed to translate these findings from animals to humans and identify the most effective time in development to give the MitoQ supplement to ‘at risk’ babies, whether that’s a particular point during pregnancy or soon after birth,” he said.
“Overcoming this next hurdle will enable it to be tested in clinical trials.”