I am
Q&A with Dr Lewan Parker
heartfoundation.org.au|Helpline 13 11 12

Q&A with Dr Lewan Parker

Identifying microvascular dysfunction as a novel mechanism of poor health in heart failure patients.

Dr Lewan Parker is a Heart Foundation Postdoctoral Fellow within the School of Exercise and Nutrition Science at Deakin University. Dr Parker has dedicated his research career to exploring exercise, biology, biochemical processes, bone metabolism, and microvascular (small blood vessel) function. These factors play an important role in managing blood sugar and overall health and disease. Dr Parker’s current Heart Foundation research is focused on Identifying microvascular dysfunction as a novel mechanism of poor health in heart failure patients.

What are you currently researching?

My Heart Foundation research project aims to determine how muscle microvascular dysfunction (poor blood flow through the smallest blood vessels in the body) contributes to exercise intolerance (difficulty exercising) and poor glycaemic (blood sugar) management in people with heart failure with type 2 diabetes. By using modern biochemical and ultrasound imaging techniques, we will directly measure small blood vessel function in muscles, heart function, large artery function, and how blood sugar levels respond to both exercise and eating a meal. These measures will be performed before and after a three-month home-based high-intensity interval exercise training program. Exercises in the program are tailored based on the participants unique situation that are suitable for their lifestyle. Examples of exercises we recommend in the program include walking, jogging, running (depending on the fitness of the individual), but also activities that can be performed at home such as cycling (if a gym bike is available), high-knee jogging on the spot, or aerobic steps (if there are stairs nearby, or something the participant can safely step up and down from in their house). This will allow us to determine whether exercise training can reverse potential defects of small blood vessels, and improve management of blood sugar levels, exercise tolerance and overall quality of life for people with heart failure and type 2 diabetes.

What difference will your research make to people’s cardiovascular health in Australia?

Many people with heart failure with type 2 diabetes are unable to exercise which is linked to worsening of blood sugar levels and faster disease progression. But we don’t yet completely understand why difficulty exercising and problems managing blood sugar levels affect these people.  Our initial findings suggest that the small blood vessels in muscle are just as important. In many cases they may be more important than the heart for regulating exercise tolerance and blood sugar levels. However, current treatment strategies are largely targeted at improving the heart. As such, we aim to provide evidence and highlight to the general public, clinicians and other researchers, that small blood vessel health is just as important as heart health. This will then enable us to develop new treatments to improve patient care and quality of life. We hope to further show that exercise training, and remotely delivered home-based high-intensity exercise rehabilitation, is an effective intervention for improving muscle small blood vessel function, exercise tolerance, and blood sugar management.

Are there any achievements or discoveries from your research you can share with us?

Our team recently published findings from a study where we investigated how eating a meal containing high-sugar alongside fats and protein) would change muscle blood flow through small blood vesselsin healthy adults. This recent work highlighted that eating this type of meal in healthy adults leads to decreases in blood flow through small blood vessels in muscles.  This effect can last for up to two hours after eating. This occurred despite a normal increase in large artery blood flow following the meal. These findings are important, as our other research has shown that small vessel blood flow in muscles normally increases after eating a normal balanced meal (for example, a meal containing low to moderate levels of sugar). The findings suggest that high-sugar ingestion, even in healthy individuals, impairs blood flow through small blood vessels in muscles. This may be related to poor blood sugar management and long-term small blood vessel problems observed with diseases such as diabetes and cardiovascular disease. Importantly, we recently showed that these small blood vessel problems could be helped by doing exercise (such as cycling) before a meal (PMID: 33191527). In some cases, this type of activity provided muscle microvascular benefits for up to 24 hours after exercising. This project pioneered the way for exercise to be used as a potential treatment for skeletal muscle small blood vessel blood flow problems. We are now looking into this further in our Heart Foundation funded research program.

How important was funding from the Heart Foundation for your work?

This fellowship has allowed me, for the first time, to commence a large-scale clinical trial in people with heart failure with type 2 diabetes. As part of this fellowship, I am now working alongside world-leading cardiologists, endocrinologists, sonographers and exercise physiologists at Deakin University and the Baker Heart and Diabetes Institute - including supervisor Associate Professor Michelle Keske (Deakin University Research Fellow) and mentors Professor Ralph Maddison (Deakin University Research Fellow) and Professor Thomas Marwick (Director and Chief Executive of the Baker Heart and Diabetes Institute). This fellowship and project have enabled me to learn state-of-the-art, specialised ultrasound and biochemical imaging techniques which only a few laboratories world-wide have optimised for use in humans. Through the new application of these techniques and by adopting an approach that involves many specialities (combining cardiology, sonography, endocrinology, and exercise physiology), this fellowship has allowed me to investigate whether small blood vessel problems in muscle impacts exercise ability, blood sugar levels and quality of life.

Do you have a message for Heart Foundation supporters?

I am deeply honoured to have received my Heart Foundation funding opportunity which recognises my research team’s hard work and significant contribution to the scientific and wider community. The ongoing support and generosity of the Heart Foundation and its donors and supporters has allowed myself, and many others, to follow our desire to improve health and quality of life through robust research. This research leads to real-world health outcomes and changes in health policy, regulations and guidelines.

Looking for that perfect gift?

Looking for that perfect gift?

Looking for that perfect gift?

Make a donation to our Christmas Appeal on behalf of a family member or a loved one and receive a personalised eCard to let them know....

Heart Health Check Toolkit

Heart Health Check Toolkit

Christmas Appeal

Christmas Appeal

Christmas Appeal

Make a donation to our Christmas Appeal on behalf of a family member or a loved one and receive a personalised eCard to let them know....

Nourishing chicken soup

Nourishing chicken soup

Nourishing chicken soup

1 hour
Serves 6

Food and healthy eating during COVID-19

Food and healthy eating during COVID-19

Food and healthy eating during COVID-19

Healthy eating and COVID-19 FAQ...

State based advocacy

State based advocacy

State based advocacy activity supporting local communities...

WEBINAR | Pressure rising: Clinical controversies and updates in hypertension

WEBINAR | Pressure rising: Clinical controversies and updates in hypertension

WEBINAR | Pressure rising: Clinical controversies and updates in hypertension

Absolute CVD risk assessment resources

Absolute CVD risk assessment resources

Resources and clinical information for health professionals...

Our Annual Reports

Our Annual Reports

Our Annual Reports

Discover our Annual reports from 2013 onwards. ...

For professionals: Aboriginal and Torres Strait Islander peoples identification training

For professionals: Aboriginal and Torres Strait Islander peoples identification training

Asking the Question of Origin course helps with identification of Aboriginal and Torres Strait Islander patients, in line with standard practice.  ...

Support us and help save Australian hearts

Support us and help save Australian hearts

Join the fight against Australia’s biggest killer by supporting the Heart Foundation.  ...

Heart Foundation Walking

Heart Foundation Walking

Heart Foundation Walking

Learn more about Heart Foundation Walking and find your local walking group....

One pan honey mustard chicken

One pan honey mustard chicken

One pan honey mustard chicken

30 minutes
Serves 2

Building physical activity into urban planning and design

Building physical activity into urban planning and design

Building physical activity into urban planning and design

Resources available for built environment professionals to help guide in the development of active outdoor and indoor spaces....

Lamb souvlaki wraps

Lamb souvlaki wraps

Lamb souvlaki wraps

5 minutes
Serves 4

Long-term recovery after a heart attack

Long-term recovery after a heart attack

Long-term recovery after a heart attack

Information to help you adjust to what could be the 'new normal'...

Sorting out your finances after a heart attack

Sorting out your finances after a heart attack

Sorting out your finances after a heart attack

Explore how to manage your financial concerns after a heart attack. ...

More Australians die of Heart Disease than any other cause.

More Australians die of Heart Disease than any other cause.

More Australians die of Heart Disease than any other cause.

And the heartache lasts a lifetime. But you can help the Heart Foundation fund life-saving research to keep more families together....

Aboriginal and Torres Strait Islander peoples: Heart Health Projects

Aboriginal and Torres Strait Islander peoples: Heart Health Projects

Aboriginal and Torres Strait Islander peoples: Heart Health Projects

Projects aimed at improving the heart health of Aboriginal and Torres Strait Islander peoples ...

Workplace giving program

Workplace giving program

Workplace giving program

Workplace giving is a simple and tax effective way for employees to make regular donations to a cause they care about. ...

Leaving a gift in your Will: A lasting legacy

Leaving a gift in your Will: A lasting legacy

Leaving a gift in your Will: A lasting legacy

One of the most powerful ways to help support a future without heart disease is to include a gift to the Heart Foundation in your Will...

Nutrition Position Statements

Nutrition Position Statements

Nutrition Position Statements

The Heart Foundation’s food and nutrition position statements have been developed to keep you informed about our position on a range of nutrition issues relating to heart health. ...

24-hour Blood Pressure Monitoring

24-hour Blood Pressure Monitoring

Blood pressure monitoring at home using a 24-hour blood pressure monitor test....

Blood pressure and your heart

Blood pressure and your heart

Blood pressure and your heart

Understand blood pressure and how it can impact your heart health....

Aboriginal and Torres Strait Islander peoples: Heart health information and resources

Aboriginal and Torres Strait Islander peoples: Heart health information and resources

Aboriginal and Torres Strait Islander peoples: Heart health information and resources

Heart disease can occur 10 to 20 years earlier among Aboriginal and Torres Strait Islander peoples and can lead to long-term health problems. ...

Christmas recipes

Christmas recipes

Christmas recipes

Find heart healthy festive recipes. ...

Seafood recipes

Seafood recipes

Seafood recipes

Find heart healthy seafood recipes...

Donate Monthly | Become a Regular Donor

Donate Monthly | Become a Regular Donor

Donate Monthly | Become a Regular Donor

Join the fight against heart disease....

Taking your heart medicines

Taking your heart medicines

Taking your heart medicines

Know what your heart medicines are for and how to take them. ...

Returning to work after a heart attack

Returning to work after a heart attack

Returning to work after a heart attack

Discover how to plan for your return to work....