Despite most of the medical research community refocusing their work on the COVID-19 pandemic crisis and other studies getting delayed as labs closed to avoid spreading the disease, several significant key developments in the fight against heart disease and stroke emerged in 2020. The American Heart Association, the largest non-governmental funder of heart and stroke related research in the United States, has been compiling an annual list of major advances in heart disease and stroke science since 1996.

A complete review of the Association’s top ten picks for leading cardiovascular-related research accomplishments published in 2020 can be found here. An overview of pivotal research highlights selected by the volunteer medical experts of the American Heart Association, a global force for longer, healthier lives, includes:

1. Unique therapy could transform how hypertrophic cardiomyopathy is treated.

About 1 in every 500 people has hypertrophic cardiomyopathy (HCM), in which the heart muscle thickens and can stiffen, making it harder for the heart to pump blood. A phase 3 study, EXPLORER-HCM, tested a first-in-class medicine, mavacamten, that showed promise for treating this condition.

2. More treatment isn’t necessarily better in coronary heart disease.

When the coronary arteries become progressively narrowed, blood flow to the heart is inadequate, a clinical situation known as coronary ischemia. A massive international trial explored whether early, aggressive care involving coronary angiography to visualize reduced blood flow to the heart, plus bypass surgery or coronary interventionto improve blood flow when needed, could prevent more heart problems and heart-related deaths than could initial treatment with medicines alone. The trial, known as ISCHEMIA, encompassed more than 5,000 patients in 37 countries. The aggressive approach was found to be no better than traditional treatment. In a sub-study looking at patients with chronic kidney disease, the aggressive treatment was linked to more than triple the risk of stroke.

3. New findings may reshape the first line in the treatment of atrial fibrillation.

At least 2.7 million Americans are living with atrial fibrillation (AFib), a condition that causes an irregular heartbeat. New studies suggest that more active treatment strategies – including medication, ablation and catheter balloon cryoablation – within a year of diagnosis can head off grave health consequences of AFib.

4. America continues to have a growing hypertension problem.

While overall prevalence of hypertension has crept up to 46% in recent years, studies in 2020 highlight the threat of high blood pressure in pregnancies, a broader struggle to control the condition and gaps in scientists' understanding of its underpinnings.

5. Sometimes a diabetes drug isn't just a diabetes drug.

Several studies in 2020 highlighted the benefits of a class of medicines called SGLT2 inhibitors, which are used to treat type 2 diabetes but can also reduce serious renal problems and heart failure hospitalizations.

6. Groundbreaking therapies aim to tame troublesome cholesterol levels.

Cutting-edge molecular gene expression therapy, new insights into the role of an LDL variant called lipoprotein(a) and progress in treating a rare, deadly condition called homozygous familial hypercholesterolemia were among the important findings in addressing cholesterol management in 2020.

7. Stroke prevention studies highlight diverse tactics.

A new minimally invasive procedure called transcarotid artery revascularization compared favorably to open surgery in restoring blood flow in the carotid artery. Several other studies found positive outcomes with combination drug therapies to reduce stroke risks.

8. Physical activity is a step toward better health.

Two recent studies highlight the potential benefit of simply walking on a regular basis. Doubling daily steps from 4,000 to 8,000 was associated with cutting the odds of dying in half; and using smart technology helped overcome the challenge of accurately tracking physical activity for long periods.

9. Science is just beginning to shed light on COVID-19's mysteries.

Insights into the deadly novel coronavirus (COVID-19) dominated much of the medical world this year. Early findings showed that cardiovascular complications were prevalent among many COVID-19 patients, calling for the need for more research into specific mechanisms of the disease. The American Heart Association funded $2.4 million in fast-tracked COVID-19 research grants and established a COVID-19 Cardiovascular Disease Registry powered by the Association’s Get With The Guidelines,® an in-hospital quality improvement initiative which already has tracked more than 26,000 COVID-19 patients.

10. Finally, don't forget the flu. It's hard on the heart.

While deaths from COVID-19 continued to rise across the world, new findings reiterate the importance of influenza prevention, especially among at-risk patients including those with heart disease.