The vascular tree of an academic career: tortuous, turbulent and dysfunctional, interspersed with glorious moments of laminar flow

The vascular tree, from modest, single-layered capillaries to large, multilayered muscular conduit arteries, is a complex network of hollow tubes that transports life-giving oxygenated and nutrient-rich blood to every cell. It is also home to arguably one of the body’s most important and largest selectively permeable biological membranes: the endothelium. This single layer of cells lining the inside of all blood vessels is remarkably resilient, yet also vulnerable and prone to becoming dysfunctional when exposed to harmful circulating factors. Endothelial dysfunction, one of the earliest events in the pathogenesis of several cardiovascular conditions, is potentially reversible, making it a valuable candidate therapeutic target. However, despite its clinical potential as a therapeutic target as well as a marker and predictor of cardiovascular disease, endothelial dysfunction is poorly described in the sub-Saharan African context, both in terms of epidemiology and underlying mechanisms. This paucity of knowledge exists against the backdrop of the current epidemiological transition in the region, which is accompanied by an increasing cardiovascular disease burden and compounded by an intricate interaction between communicable and non-communicable diseases. Of particular concern is the relationship between HIV infection and the body’s cardiometabolic system, which doubles the risk of cardiovascular disease in people living with HIV compared to the general population.

In his inaugural lecture, Hans provides an overview of endothelial research in cardiovascular physiology and disease and explains how a keen interest in vascular biology ultimately shaped his own research career. He reviews the ups and downs of his research journey, from the study of freshly isolated and cultured rodent cardiac cells, to animal organ and in vivo experiments, and the final transition to human research. Hans also discusses how his background as a medical practitioner and insights into public health challenges facing sub-Saharan Africa served as motivation to study HIV as a fast-developing yet underestimated and poorly understood cardiovascular risk factor in the region.

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Short biography

Clinician-turned-academic Hans Strijdom currently serves as professor and head of the Division of Medical Physiology in Stellenbosch University’s Faculty of Medicine and Health Sciences, as well as deputy director of the Centre for Cardiometabolic Research in Africa. His broader research focuses on the physiology and pathophysiology of the cardiovascular system, with a particular interest in vascular and endothelial biology. After initially conducting mainly laboratory, cell, tissue and organ-based research, he started shifting his focus to clinical research in 2015, when he was awarded funding via the ERAfrica programme (EU FP7) and became project coordinator of the EndoAfrica study consortium, which comprised researchers from South Africa, Austria and Belgium. EndoAfrica investigated vascular endothelial changes in people living with HIV (PLWH) and people exposed to air pollution. For the past number of years, he has published extensively on the interaction between HIV and cardiometabolic changes in PLWH. He recently received grants from the United States National Institutes of Health and the South African National Research Foundation (NRF) for a study that will explore mitochondrial function in PLWH with and without cardiometabolic disease in South Africa and Kenya. Rated C2 by the NRF, Hans has published 53 peer-reviewed articles and presented over 80 papers at national and international scientific meetings, including 13 as an invited speaker. He has supervised 17 doctoral and 19 master’s candidates and hosted seven postdoctoral fellows. Apart from his research activities, Hans is a full-time lecturer in Human Physiology for the MBChB, BSc Physiotherapy, BSc Dietetics, B Nursing, B Occupational Therapy and BScHons (Medical Physiology) programmes. His list of accolades includes several awards for general performance (research, teaching and service) and undergraduate teaching excellence from the Faculty and University.

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