Wellcome Leap launches $55m program to tackle overlooked heart disease in women
Jointly funded with Pivotal and supported by the British Heart Foundation
Around 100 million women worldwide live with stable chest pain. Each year, a subset of them — an estimated 700,000 women in the United States and Europe alone — undergo invasive coronary angiography and leave without a diagnosis. They are told their arteries look “normal.” That their hearts are healthy. That their symptoms may be anxiety.
But for many of these women, the problem is not in the large coronary arteries that cardiology has spent decades learning to detect and treat.
Instead, it lies in the smallest blood vessels of the heart — the coronary microvasculature — which remains largely invisible to standard diagnostic pathways.
Now, Wellcome Leap has announced VISIBLE, a new $55 million research program designed to close this diagnostic gap. The program is jointly funded with Pivotal, with support from the British Heart Foundation.
Shifting diagnosis from 1% to 80%
VISIBLE aims to increase the proportion of women presenting with stable angina who receive effective diagnosis and treatment for coronary microvascular disease from less than 1% today to more than 80%. The program’s backers say achieving that goal could significantly reduce the burden of cardiovascular disease for millions of women worldwide.
The scale of the problem is substantial. Among women with stable angina who undergo coronary angiography, roughly two out of three do not have an obstructive blockage in their heart arteries — the hallmark of heart disease that conventional cardiology is designed to identify. In most of these cases, evidence suggests the underlying abnormality is impaired function of the coronary microvasculature, a network of tiny vessels embedded within the heart muscle that regulates the majority of blood flow to the heart.
Because these vessels cannot be seen on standard angiography, women often embark on a years-long diagnostic odyssey. Many undergo repeated stress tests, repeat angiograms and multiple clinical visits, frequently without answers. The result is a healthcare system optimised to find focal blockages, leaving a predominantly female patient population undiagnosed and undertreated.
The consequences extend beyond persistent symptoms. Women with angina and no obstructive coronary arteries face a significantly higher risk of major cardiovascular events, including heart attack, stroke and heart failure, compared with women without these symptoms. The condition is also associated with substantial impacts on quality of life, employment and mental health, as well as high lifetime healthcare costs driven by repeated testing.
VISIBLE is designed to address these gaps through a coordinated, multi-year research effort spanning diagnosis, risk stratification, disease modelling and treatment. Central to the program is the recognition that coronary microvascular disease is not a single condition but a group of overlapping disease subtypes, or endotypes, driven by different biological mechanisms.
Four research areas
The program is structured around four research themes: developing scalable diagnostic tools that can be deployed early in the care pathway; identifying upstream risk factors and clarifying prognosis across disease endotypes; building human-relevant experimental models of the coronary microvasculature to study causal mechanisms; and testing targeted treatment strategies matched to specific endotypes.
By focusing on mechanism-informed diagnosis and treatment, Wellcome Leap aims to move beyond empiric care and create a new evidence base for managing a condition that has historically been poorly understood and under-researched.
The program is led by Birgit Vogel, a cardiologist and clinical researcher specialising in women’s cardiovascular health. Vogel is also a contributor to international efforts to address sex-based disparities in heart disease research and care.
VISIBLE is now open for abstracts and proposals from academic, industry, non-profit and government research teams worldwide. Wellcome Leap said it is encouraging applications from small, focused teams, with integration and collaboration coordinated at the program level.
For women whose chest pain has too often been dismissed or left unexplained, the launch of VISIBLE marks a significant investment in making an invisible form of heart disease visible — and in reshaping how women’s heart health is understood, diagnosed and treated.