For the one in five Kiwis fighting high blood pressure, it’s a health battle with high stakes. Though the condition can go unnoticed, it’s the single biggest risk factor for cardiovascular disease – New Zealand’s No 1 killer, accounting for almost one in three deaths, according to the Heart Foundation.
On a professional and personal level, Dr Igor Felippe knows this battle well. A postdoctoral research fellow at Manaaki Mānawa, the Centre for Heart Research at the University of Auckland, he is advancing the understanding of high blood pressure and new ways to treat it.
In particular, he’s looking at the massive issue of how to treat hypertension through a tiny sensory organ called the carotid body. About the size of a grain of rice, the carotid body sits at the fork of the carotid artery in the neck and helps sense and control blood oxygen levels as well as blood pressure.
Hyperactivity in the carotid body has been linked to high blood pressure in some sufferers of the condition. Felippe’s work has been focused on understanding the causes of this hyperactivity and exploring new potential treatments that may help bring it – and ultimately the blood pressure of these patients – under control.
“High blood pressure is a pandemic, and it’s a silent killer,” says Felippe. “It isn’t symptomatic until you have a more serious cardiovascular event or develop a cardiovascular disease. And that’s something everyone can relate to. My grandmother had to have a coronary bypass when I was young; today, I have a friend my age who’s hypertensive.”
One line of his research has identified how an excess of electrical signals sent from the sympathetic nervous system to the carotid body can cause hyperactivity. Felippe is looking at how those electrical signals might be cut off, via surgery or other treatments, to bring hypertension in some patients under control with limited side effects.
His current work is a continuation of his PhD research, which received national and international attention. This included an outstanding graduate student award from the American Physiology Society in 2021 and publication in the prestigious Cardiovascular Research journal.
“I always wanted to do something meaningful that could have an impact on society, so studying cardiovascular disease is a way to do that. All the recognition for the work, that meant a lot. It meant that the sacrifice was worth it, and it was a reason for my family to be proud.”
Asking questions
The success has been hard won – Felippe has faced a number of battles beyond the lab. Growing up in Vitória in Brazil with a single mother, his first inkling that science might provide a future path came in primary school. “I was 10 or 11 and we had a biology class where my teacher was talking about HIV and that it didn’t have a cure. I remember saying to her, ‘But what if you tried this?’ or, ‘What if you tried that?’ Obviously it’s not that simple, but I had a feeling that I wanted to find solutions to these kinds of problems.”
In the Brazilian education system, private schooling offers a greater chance of gaining a sought-after place in a state-run university, says Felippe. Although he initially attended a private school, financial hardship meant he had to shift to a public school and he and his mother moved in to live with his grandparents for a time.
About the age of 15, however, he won a scholarship that supported him to return to private schooling, and he later won another scholarship that secured him a place in Vitória’s Universidade Federal do Espírito Santo.
“At my university, the health science courses were all professional. We didn’t have options like biomedicine or physiology; the options were things like pharmacy, medicine and nursing. I always wanted to get into research and create new treatments, so studying pharmacy made sense.”
It was towards the end of his master’s in pharmacy that the connection to New Zealand occurred. His supervisor had collaborated with Professor Julian Paton, a research physiologist then based at the University of Bristol specialising in respiratory and cardiovascular disease, and suggested Felippe invite him to be an external examiner for his thesis. Paton accepted, reading Felippe’s thesis and questioning him on its content at the public defence that’s required of master’s students in Brazil.
“His thesis was meticulous,” recalls Paton. “And then he presented his work, followed by questions from the examiners, which can be quite demanding, but he did a stellar job.
“It’s very difficult to find people who are so well trained at such an early stage – not just in experimental skills but also analytical and presentation skills. Of course, he had excellent supervision from colleagues in his department in Brazil, but nevertheless he stood out to me, and I thought, ‘Crikey, I’d love to have him as a PhD student.’”
And that’s what happened. Paton was about to move to New Zealand to take up the role of director at Manaaki Mānawa and invited Felippe to undertake a PhD there under his supervision. After winning a University of Auckland scholarship, Felippe arrived here in 2018.
Cut off from home
The transition was challenging. New Zealand is cold, he says, and his English wasn’t great. Being far from home with no friends or family here was made worse when Covid-19 hit, closing borders and otherwise making travel difficult.
“My grandmother passed away during my time in New Zealand. She was one of my best friends – after my mum, the person I loved most in my life. She really took care of me and my mum when things got hard, so I really wanted to go there to say goodbye. But what can you do?”
He also faced his own health challenges. In early 2020, he started getting a husky voice that wouldn’t resolve and was later diagnosed with a respiratory disease that causes benign tumours to develop, in his case on his vocal cords. Treatment involved several surgeries and medication.
“I had to be really resilient and extra organised with work because I had to go through these courses of treatment. Covid hit at the same time, so my family couldn’t come, and I had a PhD to finish. I had to step up, focus and try to just do the work.”
Paton says Felippe’s ability to maintain productivity despite such headwinds is admirable: “He’s seized opportunities, worked hard and has been a big success story. We’re such a small nation, with limited ability to train such people simply because there aren’t many of us. Igor’s skills are quite focused in a specific area of heart research and as a country that’s a really important skill base to have here.”
Felippe’s primary goal is to gain a fellowship allowing him to continue his research in New Zealand beyond his current contract, which ends in 2025, and perhaps one day become a professor.
In the more immediate future, he’ll bring his mother to New Zealand for a long-awaited visit. “She’s crazy to get here but she hates the cold even more than me,” he says. “So I’ll need to wait until summer.”
If you have high blood pressure and would like to be involved in trials being run by Manaaki Mānawa to provide better control of the condition, email Professor Julian Paton: j.paton@auckland.ac.nz
