DALLAS, Jan. 29, 2021 – The American Heart Association — the world’s leading voluntary organization dedicated to a world of longer, healthier lives — announced today the creation of the Association’s newest network of stroke research centers. This network is supported by a $11.12M gift to scientific research from the Henrietta B. and Frederick H. Bugher Foundation, who over four decades has donated nearly $50M in cardiovascular disease and stroke research. Four multidisciplinary teams will receive research grants to begin work on developing scientific breakthroughs to improve prevention, treatment and health outcomes related to hemorrhagic, or bleeding, strokes.
Research teams at Massachusetts General Hospital, Yale University and University of California, San Francisco will receive grants to establish Centers of Excellence for scientific research on hemorrhagic stroke. The University of California, San Francisco will receive a separate, additional grant award to establish a centralized training center to grow science curriculum and career-development training opportunities to help create the next generation of stroke scientists and researchers.
Hemorrhagic strokes, which make up about 13% of all stroke cases, are caused by a weakened vessel that ruptures and bleeds into the surrounding brain. The damage can impair cognitive abilities including thinking, moving, feeling, talking, understanding and writing. More than two-thirds of people (about 50,000 each year) will survive their hemorrhagic stroke, but all survivors are at very high risk for worsening brain health as they age. Black and Hispanic patients are at highest risk.
“While hemorrhagic strokes are less common, they contribute a disproportionately high burden of mortality and morbidity. To address the serious consequences of hemorrhagic strokes, we need more research focused on all aspects of the disease from basic mechanisms to prevention, treatment and recovery if we are to transform and advance the field,” said American Heart Association president Mitchell S.V. Elkind, M.D., M.S., FAHA, FAAN, professor of neurology and epidemiology at Vagelos College of Physicians and Surgeons and attending neurologist at New York-Presbyterian/Columbia University Irving Medical Center. “We’re excited that with the support of the Bugher Foundation we can fund projects that promise to ultimately make it easier for patients and their providers to work together in achieving longer, healthier lives for all.”
“Over the next four years, we’ll have some of the most creative minds in cerebrovascular research collaborating on basic, clinical and population scientific studies focused on solving the critical challenge of how to prevent people from experiencing dangerous bleeding strokes and how to better treat those who do,” said Karen Furie, M.D., M.P.H., chair of the department of neurology at The Warren Alpert Medical School of Brown University in Providence, Rhode Island, who led the American Heart Association’s peer review team for the selection of the new grant recipients. “Particular attention will go to determining why some populations are more vulnerable to risks and complications of these types of strokes and how we can address gaps in care among these people.”
The projects, which commenced on January 1, include:
- American Stroke Association-Bugher Foundation Center for Excellence in Brain Health for Hemorrhagic Stroke at Massachusetts General Hospital in Boston – Led by Jonathan Rosand, M.D., M.Sc., a professor of neurology at Harvard and founder of the McCance Center for Brain Health at Massachusetts General Hospital, this team will undertake three projects designed to answer fundamental questions of brain health and health care disparities. Their clinical project will study how social determinants of health and social networks influence blood pressure control, which is strongly associated with brain health after a hemorrhagic stroke. Those findings, combined with clinical, imaging and genetic data, will be used to design interventions to improve blood pressure control. Within their population project they’ll create a brain health risk assessment tool using the electronic health record, then perform a clinical trial among physicians to assess how improved resource use can optimize brain health after a bleeding stroke. They will also build and test polygenic risk scores and confirm their usefulness in diverse populations. The team’s basic project will investigate cortical superficial siderosis (CSS), a novel biomarker for recurrent bleeding in hemorrhagic strokes, to identify the biology linking CSS to clinical deterioration. Their goal is to generate targets for novel therapeutics that can ultimately be proven to preserve brain health after a hemorrhagic stroke.
- Yale AHA/Bugher Center of Research Excellence in Hemorrhagic Stroke Prevention & Treatment at Yale University School of Medicine in New Haven, Conn. – Led by co-directors Lauren Sansing, M.D., M.S. an associate professor and academic chief in the Division of Stroke and Vascular Neurology at Yale School of Medicine, and Kevin Sheth, M.D., a professor of neurology and neurosurgery and associate chair for clinical research in the Department of Neurology at Yale, this team will seek to personalize the treatment of high blood pressure, the most common risk factor for hemorrhagic stroke patients. Their first project will include studying how the body’s immune system signals the brain during a bleeding stroke and how current blood pressure medications affect those signals for better or worse. The second project will study which blood pressure medications are best at lowering blood pressure in people who have had a brain bleed, using measurements of kidney proteins to determine efficacy in the medications. This project will begin to study a one-time kidney procedure as a potentially creative way to achieve better blood pressure control. The team’s third project will focus on genetics to help figure out how a particular medicine can work in a specific person. The ultimate goal of team will be to develop a personalized medicine tool to deliver the individual risk information to treating providers to aid in decision-making.
- Improving Outcomes of Children with Hemorrhagic Stroke and Brain Arteriovenous Malformations at the University of California, San Francisco – Led by Heather Fullerton, M.D., M.A.S., chief of child neurology and medical director of the Pediatric Brain Center at the University of California, San Francisco’s Benioff Children's Hospital, this team will focus on hemorrhagic strokes in children, which account for more than half of incident strokes in this age group. They’ll specifically be studying brain arteriovenous malformations (bAVM), abnormal connections between arteries and veins in the brain. Usually present at birth, these malformed vessels can change over time in ways that make them more likely to rupture and injure the surrounding brain. Although doctors can cure bAVMs and prevent stroke through a surgery or treatment with radiation, those therapies can also injure the brain. Better information is needed to help guide treatment decisions. The team’s first project will look at brain pictures and blood tests that can help predict dangerous changes to a bAVM and the second project will use imaging to map out brain networks around malformations to help preserve brain functions during treatment. Finally, the team will work with the International Pediatric Stroke Study, which includes more than 6,000 children with ischemic stroke, to build a new patient registry for children with brain AVMs and hemorrhagic stroke. Analysis of patient records from that registry can be used to better understand how factors like race, education and where a child lives can impact their risk and experience with bAVMs and bleeding strokes. They will use all project results to develop a decision tree to guide the care of brain AVMs in children.
A grant will also be awarded to a team from the University of California, San Francisco, (UCSF) to establish the Bugher Foundation Hemorrhagic Stroke Scholars Program: A Centralized Research Training and Leadership Center. Under the direction of Nerissa Ko, M.D., M.A., a professor of neurology at UCSF Weill Institute for Neurosciences, this team will design and share specialized curriculum, resources and tools to help train researchers at the three centers, as well as establish protocols to train the next generation of stroke scientists for the future.
For more than 40 years, the Bugher Foundation-American Heart Association collaborative has spurred innovation through multi-disciplinary approaches to cardiovascular and cerebrovascular research, contributing nearly $50 million in research and programs. This includes establishing groundbreaking strategically focused research networks in stroke and training more than 150 post-doctoral fellows to-date. The Bugher Foundation is the Association’s single largest donor to stroke research.
Since 1949, the American Heart Association has supported than $4.6 billion in cardiovascular, cerebrovascular and brain health research, making it the largest not-for-profit funding source for cardiovascular and cerebrovascular disease research next to the federal government.
- The American Stroke Association receives $11.1 million gift from The Henrietta B. and Frederick H. Bugher Foundation to fund targeted research network in hemorrhagic stroke
- Animation of a hemorrhagic stroke
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The American Heart Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.
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