Coronary microvascular dysfunction (CMD) is a common, but underdiagnosed, condition that can lead to heart attacks, heart failure and ultimately death. Current treatments focus overwhelmingly on traditional coronary artery disease, and so CMD patients often become forgotten. MICROFIT is a specialist-designed, tailored diet and exercise rehabilitation programme aimed at improving overall physical health, including blood pressure, waist size and cholesterol levels, for CMD patients. Combining HIIT exercise with a dietary plan to target all elements of physical health, this programme aims to improve both quality of life and reduce occurrences of serious cardiac events.

Coronary microvascular dysfunction (CMD) is a condition that causes repeat hospital visits, heart attacks, heart failure, and a significantly increased risk of death. Unlike traditional coronary artery disease, in which blockages in the large arteries occur, CMD affects the small vessels known as the micro vessels. Although small they are vital to heart health, representing 90% of the heart’s blood supply. CMD is common, approximately two in every three patients who get tested for chest pain (angina) have no blockages of their large blood vessels.

CMD disproportionally affects women, particularly around the time or after menopause, often presenting differently from traditional heart disease. Unfortunately, this has often led to a high misdiagnosis rate. While significant strides have been made in the treatment of conventional coronary artery disease, research and treatment options for those with CMD have remained extremely limited.

A diagnosis of CMD often co-exists with other health conditions (e.g. being overweight or diabetes). These conditions not only damage the small blood vessels in the heart but in other organs of the body too. This means that treating CMD requires a change in focus from treating the heart in isolation to treating the individual as a whole.

In order to do this, the team at Bath NHS Foundation Trust, led by Dr Ali Khavandi, have developed a novel programme called MICROFIT. MICROFIT is a 24-week diet and exercise rehabilitation programme designed by a team of specialists to specifically tackle CMD in a new way. The aim is to provide individualised and meaningful support to patients. Each patient will have a personalised exercise and dietary plan. A personal trainer will coach high intensity exercise (HIIT) sessions on a one-to-one basis at local fitness facilities with additional home-based sessions.  There will also be support from a dietician to encourage tailored dietary treatments that target overall physical health, including blood pressure and waist size, among other factors. A cardiologist will ensure that patients are on the best medications to treat their symptoms and any associated conditions (e.g., high blood pressure).

MICROFIT is designed to help patients maintain healthy lifestyle changes in the long term. It is expected that there will be improvements in patient’s weight, blood pressure, diabetes, fitness and as a result blood flow to the heart. This will then translate to patients experiencing fewer chest pain symptoms and a reduced requirement for medication. In turn, the risk of serious heart problems like heart attacks and heart failure should fall. MICROFIT will offer a valuable new, sustainable treatment option for this important, but often neglected patient population.