Getting to the heart of hypertension

Professor Alta Schutte is unit director: South African Medical Research Council Unit on Hypertension and Cardiovascular Disease. She holds the Department of Science and Technology-National Research Foundation South African Research Chair: Early Detection and Prevention of Cardiovascular Disease in Africa at the Faculty of Health Sciences, North-West University (NWU). She is also the Professor in Physiology for the Hypertension in Africa Research Team (Hart) at NWU.

Schutte entered her field of study because, although she had little interest in becoming a medical doctor, she wanted to better understand the ins and outs of how disease develops and what we can do to change it.

Every year 10-million people around the world die needlessly because of high blood pressure or hypertension, making it the planet’s single biggest killer. They will suffer a stroke, have a heart attack, or die from another related cardiovascular complication.

A global analysis of 19.2-million participants found that the highest blood pressures recorded worldwide were in Africa (Lancet 2016). This disease burden is greatest in sub-Saharan Africa, which is why Schutte’s research focuses on understanding and identifying early predictors for the development of hypertension in South Africa.

By employing cutting-edge research proven to predict hypertension and cardiovascular outcome in Africa, precision medicine may lead to novel strategies in preventing and treating hypertension. However, the severe lack of longitudinal studies on the development of hypertension in Africans has hampered investigations to identify health behaviours and biomarkers for the condition.

During her PhD and postdoctoral fellowship, Schutte obtained vast experience working in epidemiological studies on hypertension in black populations in Africa and Aboriginal populations in Australia. This work stimulated an interest in environmental exposures and how these may contribute to the exceptionally high burden of cardiovascular disease in Africans.

These experiences equipped her to design and lead several trans-disciplinary studies at NWU. She was also co-primary investigator of the South African leg of the multinational Prospective Urban Rural Epidemiology 2005-2015 (Pure) study, steered from Canada.

Schutte was the founding director of Hart in 2008. Since its establishment, the impact and quality of research and levels of international collaboration have escalated, as well as the employment of state-of-the-art techniques for understanding cardiac and vascular health.

Several pilot studies were conducted to gain a basic understanding on the cardiovascular health of our population and Hart built on these experiences, starting with the longitudinal Pure study and the African-PREDICT study, which has received several awards for its novel approaches.

Outcomes from these research projects have been far-reaching, from expanding the measurement of blood pressure to all adults as part of any medical care (and not just measuring the blood pressure of elderly patients) to impacting on clinical practice guidelines (International Society of Hypertension; Pan-African Society of Cardiology Hypertension Roadmap) and advice to health policymakers throughout Africa. This has also included the publication of fact sheets by the World Hypertension League on Prevention of Hypertension in Africa, as well as salt intake.

“I am absolutely delighted to be paid to do what I love most,” she says. “As I have moved from a junior to senior scientist, I found it so rewarding seeing how young scientists develop around me and what I can do to contribute to that. I also find it highly rewarding to see how our small research group developed over the past 15 years from five to 13 highly active academics, with a vibrant research culture.”

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