Cardiologist’s mentor sparks “lifelong passion” for heart failure and clinical research
Drew Ambrosy, MD, a practicing cardiologist with more than 100 publications under his belt, joined the Division of Research as a research scientist in 2018. His interests include the full spectrum of cardiovascular disease, particularly heart failure, as well as health services, delivery science, and clinical trials. “Working at the Division of Research has been the opportunity of a lifetime, and I am thrilled to come to work each day,” Ambrosy says. We asked him 5 questions:
Thinking back, is there a single moment in your life that sparked your interest in what you’re doing now?
At the beginning of my 4th year of medical school, I switched my specialty from anesthesiology to internal medicine, with the intent to eventually pursue fellowship training in cardiovascular medicine. Soon after, I started working on research under the mentorship of Dr. Mihai Gheorghiade, a renowned clinical trialist at Northwestern University. Dr. Gheorghiade told me the first time we met that “research is a drug” and he was going to make me “an addict.” The experience sparked a lifelong passion for heart failure and clinical research.
I was jointly recruited to Kaiser Permanente by Alan Go, MD, at the Division of Research, and Ivy Ku, MD, cardiology chief at Kaiser Permanente San Francisco Medical Center. Alan has been a supportive and responsive mentor, and the Go group is an amazing collection of project managers, biostatisticians, programmers/analysts, and research assistants who are talented, professional, and collegial.
How did you decide to pursue a concurrent career in research?
I started doing research and writing papers as I was learning clinical cardiology. At the time, I was taking care of a lot of patients admitted for heart failure. I noticed that although most patients presenting with heart failure improve rapidly and dramatically in response to standard decongestion therapy, a small subset go home with residual signs and symptoms of fluid overload.
I used a large clinical-trial database to describe the in-hospital trajectory of signs and symptoms of heart failure and reported that residual congestion when patients are discharged from the hospital was associated with higher subsequent risk of readmission or death. To this day, my research interests and clinical practice remain intimately linked, and I firmly believe patient care drives the scientific process, and vice versa.
How has cardiovascular research changed over the decades? Where do you see it headed in the future?
The treatment options for the prevention and management of cardiovascular disease and heart failure have improved tremendously over the past couple of decades and patients are living longer with heart disease. To some extent, we are victims of our own success and are now seeing a marked increase in the prevalence and incidence of heart failure, which has tremendous socioeconomic implications. As we move forward, the focus in cardiovascular disease and heart failure needs to shift from treatment to prevention.
What have we learned about the prevention of heart disease that would be useful to people who are trying to keep healthy?
The first sign of cardiovascular disease may be a heart attack or stroke, so it is important for patients to embrace a heart-healthy lifestyle early on in life, including diet, exercise, limited alcohol consumption, and smoking cessation. More than 70% of adults are overweight or obese, and on average Americans spend 11 hours per day sitting. Patients can improve their cardiovascular health dramatically by losing about 10% of their body weight, engaging regularly in moderate-intensity physical activity, reducing alcohol intake, and quitting smoking.
In your free time, what do you like to do?
I like to spend as much time as possible with my wife, Joanna, and our two dogs, Cali, a 12-year-old shepherd-terrier, and Carolina, a 3-year-old beagle-terrier. On the weekends we go to San Francisco’s Ocean Beach for a long walk or try to explore a new neighborhood looking for new spots for “date night.” I am an avid skier, so we really enjoyed all the snowfall Lake Tahoe experienced this season. Finally, my wife and I love to travel and have a map in our apartment where we mark each new destination we visit with a pin. This year we added London, Paris, and Iceland to the map.
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