AS A world-leading heart surgeon, internationally reputed scientist and medical director of the British Heart Foundation (BHF), Professor Sir Nilesh Samani has been at the forefront of the fight against heart disease for well over 30 years.
When this Kenyan-born, Leicester-based physician began his medical training in the 1970s, just a third of people survived heart attacks. Nowadays the survival rate is more than seven out of 10 and he has played no small part in the improvement.
Thanks to the introduction of genetic testing – which Sir Nilesh pioneered – as well as angioplasty, statins and new surgical techniques, treatments for heart disease have been transformed. “Our ability to treat heart and circulatory disease has advanced enormously and I’ve had the privilege to live through this,”
he says. “I think there have been more advances in the treatment of heart and circulatory disease in the last 20 or 30 years than almost any other area of medicine – maybe only cancer comes close.”
For most people, doing any one of Sir Nilesh’s current jobs might seem like a daunting professional responsibility. He seems to take it all in his stride. His role with the BHF – a position he took up in 2016 – makes him one of the world’s most significant commissioners of cardiovascular research, responsible for funding more than half of all research into heart disease in the UK with an annual budget of over £100 million. At the same time, he is the BHF’s public voice and therefore one of the country’s leading public health spokesmen.
In addition, this indefatigable 63-year-old continues in his roles of consultant cardiologist at Glenfield Hospital, Leicester, while also heading a world-leading medical research team at the city’s university. There are no two ways about it: it’s an extraordinarily busy life. As a cardiologist, Sir Nilesh could be woken at three in the morning to put a life-saving stent in someone’s arteries, then a few hours later, asked by the media to comment on some new research findings.
He must also find time to consider the merits of the many research proposals that come across his desk from medical faculties around the world looking for vital funding. And then there is his own team’s research to direct at Leicester university where he is professor of cardiology. It’s a huge work commitment but not one he seems ready, just yet, to cut down on. For one thing, he finds the hands-on contact with his hospital patients informs and enhances his own research work and also his role with the BHF.
“Patients are at the heart of everything we should be doing,” says Sir Nilesh. “The questions I want to answer in the lab are often informed by what I have seen in the ward. This is not only in terms of treatments, but also causes and prevention because, ultimately, the goal of the BHF is to prevent heart disease.” Sir Nilesh’s appointment three years ago as BHF medical director came shortly after he was given a knighthood for services to medicine and medical research.
Both were met with universal approval from the medical profession, which is aware of the important cardiovascular research he and his team had carried out for over two decades. Aided by a substantial BHF grant, Sir Nilesh and BHF professor Stephen Ball in Leedshad set up the groundbreaking BHF family heart study in the 1990s, focusing on families in which at least two people suffered from coronary heart disease.
The study, which has informed treatment practices ever since, discovered that people born with certain genetic predispositions face a significantly higher risk of suffering a heart attack at a relatively young age.
The family heart study helped pave the way for new approaches in both prevention and treatment of heart attacks, including giving lifestyle advice and intervention at an earlier age than previously. “We can’t do that for the whole population, but if you can identify people at high risk, you can do much more,” explains Sir Nilesh.
“For example, in future we could give statins early to people born with the highest risk who could get the maximum benefit in terms of preventing heart attacks.” Sir Nilesh’s early advocacy of the use of statins to combat the risks of heart disease, especially among older people, has been increasingly vindicated by a growing body of research suggesting that not only are they safe to use, they also lower the risks by a significant margin.
In February this year, the findings of a major study, part funded by the BHF, revealed that statin therapy did not increase the risk of deaths from diseases not linked to the heart, including cancer. Sir Nilesh believes that this latest research, which was carried out jointly by scientists at the universities of Oxford and Sydney, can help combat a popular misconception that statins can increase the risk of cancer.
“Concern has been raised about the benefits of statins in older people. This large analysis provides powerful evidence that statins reduce heart attacks and strokes in older people, as they do in younger people, and are safe,” says Sir Nilesh.
“Age should not be a barrier to prescribing these potentially life-saving drugs to people who are likely to benefit.” Sir Nilesh, whose mother tongue is Gujarati, was born in the small market town of Nanyuki, Kenya, in 1956. He attended the Lenana school in Nairobi and then, after his parents moved to Britain, Charles Keene College, Leicester. His interest in medicine was sparked as a child when he noticed how the town doctor in Nanyuki was the one who commanded the most “respect.”
He studied for his medical degree at Leicester University and has continued to live in the town ever since. An avid Leicester City fan, he is married with two sons. Sir Nilesh points out that there are few aspects of the many advances in heart treatments that have not been aided by BHF, and is looking forward to more breakthroughs in treatment options in the coming years.
“I think the next 20 years will be even better. The BHF has a critical role to play in terms of making sure research happens and is carried out with patients, and the benefits to them in mind.
