The Future of Cardiometabolic Research: Five Questions Shaping the Next Decade

Cardiometabolic research is continually evolving beyond explanations centred on single causes of disease.  

Bablu Singh, Head of Clinical Physiology at Richmond Pharmacology, recently co-authored research published in the Journal of the American College of Cardiology (JACC), providing a timely example of this broader shift in perspective. The findings illustrate how a patient’s prognosis may depend not only on the severity of a single structural abnormality, but also on its relationship with wider cardiovascular factors.

With emerging research revealing how interconnected conditions and interactions across multiple biological systems can influence patient outcomes, we asked Bablu a few questions on what he sees as the most important developments shaping the cardiometabolic field and future of drug development.

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‍Your recent  JACC  publication focused on myocardial ischaemia. Why is understanding disease mechanisms so important in cardiovascular research?  

Bablu Singh: Disease mechanism helps in understanding the underlying causes of cardiovascular disease, helping us move beyond simply treating symptoms. Our JACC publication amongst others aimed to identify the cause of symptoms in moderate Aortic Stenosis with the help of stress echocardiography. In a research setting, the knowledge is essential in identifying novel therapeutic targets by understanding the cellular and molecular processes to reduce ischaemic injury and improve clinical outcomes in patients. This approach helps avoid a “one-size-fits-all” approach, and understanding why disease develops and progresses allows us to deliver personalised care, better patient selection for clinical trials and a greater likelihood of bringing meaningful innovations to patients.

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‍Cardiovascular disease rarely exists in isolation. How are conditions such as obesity, diabetes and metabolic dysfunction changing the way researchers think about heart disease?  

Bablu Singh: Cardiovascular diseases are complex and deeply interconnected with metabolic health – obesity, type 2 diabetes mellitus, hypercholesterolaemia and related metabolic disorders are active contributors to the development and progression of cardiovascular disease. Researchers are increasingly taking a broader view of heart disease, considering the interactions between the heart, liver, kidney and metabolic systems. This has given rise to the expanding field of cardiometabolic medicine.

A good example is the emergence of therapies initially developed for diabetes that have demonstrated significant weight loss and cardiovascular benefits.

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‍We've seen huge advances in cardiometabolic medicines over the past decade. What developments excite you most?  

Bablu Singh: From my perspective working in clinical research at Richmond, gene editing and gene silencing technologies is especially exciting because of their potential to advance personalised medicine. Recent advancements have shown that these technologies can effectively target genetic drivers of cardiometabolic diseases, such as APOC3 and ANGPTL3, showing promising results in early clinical research. CRISPR-based technologies are being investigated to study and treat cardiovascular diseases, demonstrating the wider potential of genetic medicines to support more personalised approaches to treatment. More broadly, gene therapy encompasses a range of approaches that modify gene expression or function, opening new avenues for treating diseases that have historically been difficult to address.  

Richmond also homes the Richmond Research Institute (RRI) which has a research programme with King’s College London developing a remote home-based tool to track a patients condition using only the electrical signal from the patient (an ECG). This research generates valuable evidence that can inform the design of future clinical studies and approaches to treatment.

I am also encouraged by the growing focus on prevention. Historically, cardiovascular medicine has often focused on managing established disease. Today, many emerging therapies and research programmes aim to intervene earlier, reducing disease burden before significant damage occurs. This shift has enormous potential for improving long-term population health. This broader approach has led to offering a variety of cardiovascular diagnostics assessments at Richmond, including participants with a very low threshold of CVD.

These range from simple ECG, Holter monitoring and telemetries to more advanced assessments such as abdominal ultrasound, FibroScan, renal ultrasound, echocardiography and stress echocardiography for the research participants, providing access to a variety of specialist assessments under the same roof.

Why is early clinical research so important for bringing new cardiovascular therapies to patients?  

Bablu Singh: Early clinical research is the bridge between scientific discovery and real-world patient benefit. These early studies are critical because they generate the data needed to make informed decisions about future development.

At Richmond Pharmacology, we see firsthand how important this phase is. High-quality early clinical research allows innovative therapies to be evaluated efficiently while maintaining rigorous safety standards. Advanced assessment techniques, including cardiovascular imaging and physiological monitoring, provide valuable insight into how new treatments affect the body.  

What do you think the next five to ten years will look like for cardiometabolic research? 

Bablu Singh: I believe the next decade will be characterised by increasingly personalised and preventative approaches to cardiovascular care. Advances in genetics, biomarkers, artificial intelligence and imaging will enable researchers to identify risk earlier and tailor treatments more precisely to individual patients. Artificial intelligence, in particular, has the potential to significantly accelerate the journey from scientific discovery to real-world patient benefit by improving trial design, participant selection and data analysis.

Imaging will continue to play an important role, not only in helping us better understand disease, but also in shaping how healthcare and clinical research are delivered. I believe we will see more patient-centred clinical trials, where assessments such as echocardiograms, blood pressure monitoring, blood tests, ECGs, Holter monitoring and ultrasound scans can be carried out closer to a participant's home, rather than requiring frequent visits to research centres.

This approach has the potential to make participation easier and more convenient for patients, reducing travel and disruption to their daily lives. It could also improve recruitment and retention in clinical trials while ensuring studies better reflect real-world populations. Ultimately, bringing research closer to patients will support more efficient clinical trials and help generate evidence that can be translated into better patient care.

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To summarise:

Bablu’s responses point to a clear direction of travel: cardiometabolic research is becoming more integrated, more precise and increasingly focused on understanding how multiple systems interact to shape patient outcomes.

For Richmond Pharmacology, this reflects the broader work we are doing across cardiometabolic research, where robust clinical science, meaningful biomarkers and a deeper understanding of patient risk are helping to inform the development of future therapies.

Developing a cardiometabolic programme?

Speak to our team about how Richmond Pharmacology can support your early clinical development, from study design and participant recruitment through to specialist cardiovascular assessments and clinical delivery.

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References

1 Vamvakidou A, Hampson R, Singh BK, et al. (2025). Myocardial Ischaemia, Not Valve Hemodynamics, Determines Prognosis in Patients with Symptomatic Moderate Aortic Stenosis. JACC, 85(12 Suppl), 2251.

2 Laffin LJ, et al. (2025). Phase 1 Trial of CRISPR-Cas9 Gene Editing Targeting ANGPTL3. New England Journal of Medicine, 393, 2119–2130.