Imagine waking up in the morning, sleepily checking your smart wearable technology and discovering exactly which supplements you should take, how much exercise you need and how to adjust your diet for a longer, healthier life. Imagine a reality where your health technology uses nearly imperceptible body sensors to continuously collect data, monitor various chemical levels inside your body and interpret vital signs. Each day, you receive clear, actionable reports with recommendations to optimize your health. This is the future of vascular health — the future envisioned by Nick West, Chief Medical Officer for Vascular at Abbott. Solving Current Vascular Health Concerns The current approach to treating vascular disease focuses largely on symptom management. Researchers are working to find solutions that provide a more effective cure, but in the meantime, healthcare costs are rising. 'We've come up with wonderful technologies that reduce symptoms and extend life, but we need to be able to reverse the overall expense growth of healthcare,' West said. 'A healthy person is very inexpensive in the healthcare system, so we need to ensure that we're keeping people as healthy as possible to reduce costs.' As the saying goes, an ounce of prevention is worth a pound of cure. With the development of more sophisticated health technology, detecting earlier signs of vascular health problems and preventing cardiovascular disease will become much easier. The Next-Next Generation of Wearable Health Technology The onset of vascular disease begins in a tiny yet essential part of the vascular system called the endothelium. This one-cell-thick layer is present in every artery, vein and capillary. Damage to the endothelium was found to be the 'hallmark of human diseases' in a study published by the International Journal of Biological Sciences. Endothelial damage in the coronary arteries can set off a cascade of events that eventually lead to a narrowing of the arteries, reduced blood flow and, potentially, a blockage, resulting in a heart attack or even a fatal cardiac arrest. That sounds bad but read on. West posits that in the next 20 years, sensors will be able to detect damage to the endothelium and monitor the health of other important layers of the artery and the heart muscle itself. These sensors could transmit this information to a wearable device, which would interpret the data and offer recommendations to alter diet or physical activity, change medication dosage or visit a physician. 'Our bodies generate a tremendous amount of information about our cardiovascular health — heart rate and rhythm, blood pressure, oxygen saturation and even local changes in blood chemistry and viscosity are just a few things that we could measure with sensors that are small and easy to wear. A smart and capable device can evaluate the status of your health,' West said. 'We can then use the data to help ourselves and our physicians create a personalized and precise treatment regime that will take good care of our cardiovascular system before problems can even begin.' These wearables may also help us share critical data with others. 'This information can be easily shared among family members — such as with adult children who care for their elder parents or with parents monitoring the health of their children, who may not necessarily be as proactive,' West said. 'It is something that becomes a way to communicate and create important action throughout a social network.' Incredible Imaging Currently, a technology called optical coherence tomography (OCT) uses tiny catheters inserted into the heart arteries to analyze and understand the geometry, composition and health of the tissue using imaging based on reflectivity of red light. In the next 20 years, West predicts this health technology will progress to help provide better treatments and outcomes. Future innovation in imaging could help identify the exact nature of a condition inside the body and provide better diagnostic information. 'We'll be able to combine our current knowledge and understanding of the vessels in terms of whether they are healthy or diseased, with information on local flow and pressure, to help predict whether future adverse events are likely.' West said. 'We [would] have the ability to peer into the body with great precision and use advanced signal analysis and image detection algorithms to give our doctors the ability to treat each patient in a very customized, precise and personalized manner.' Harnessing the Body's Power Preventing the body from damaging its cells is an essential focus of research and development. 'Whether it's stress, diet or other diseases, the inflammatory response is something we need to address to preserve health,' West said. 'What was once originally a protective response has now turned into a detriment to our overall health and cause of disease.' He proposes taking control of the source of the inflammatory response. Using the nervous system's electrochemical signals, physicians could communicate with your brain's nerves and send signals to stop producing the inflammatory response or to stimulate beneficial responses. 'We already do that with our neuromodulation group to modulate pain signals for people with severe, intractable pain,' West said. 'We can also help patients who have tremors or other neurological diseases.' Future health technology could help physicians use the body's mechanisms to treat vascular disease, encourage cells to regenerate and regrow tissues within the body. Research into using these signals to treat cardiovascular disease is already in progress and is expected to mature into a treatment option within the next decades. Better Tools to Handle a Complex Disease As people age, comorbidities such as diabetes, cancer, osteoporosis and lung disease complicate vascular system treatments. But West predicts future treatment tools will overcome these challenges, too. 'Phenomenal new advances in materials technology has developed media that are biologically friendly, and when coupled with the exponential increase in the technological capability of microminiature computers, means our interventional tools, such as implants and diagnostics, will become more intelligent and effective,' West said. '3D printing and new manufacturing capabilities to create devices and sensors on an extremely small scale will create the diagnostics for clinicians to do a much better job in extending the health span, just because the tools will be better, smarter and more effective.' With improved health technology, West predicts, procedures will be more straightforward and comprehensive with longer-lasting results, faster recovery times and fewer side effects. 'Because the tools will be that much more capable, the risks are reduced considerably, with no worries about follow-up visits and medications,' he said. In the near future, medical breakthroughs in preventative healthcare technologies and improved treatment methods will likely overcome many of the primary obstacles of living with a cardiovascular condition. We've come a long way in the treatment of cardiovascular disease, and thanks to important breakthroughs in technology, engineering and research, the future of vascular care looks bright.