How a cancer diagnosis transformed one scientist’s fight against hypertension

Professor Francine Coelho Marques is Deputy Director (Discovery) of the Monash Victorian Heart Institute. She’s a cardiovascular researcher who focuses on tackling hypertension from an innovative angle – through microorganisms in the gut, not just the heart.

This month, Professor Marques was awarded the Australian Academy of Health and Medical Sciences Jian Zhou Medal, given annually to a rising star of Australian health and medical science. The 2025 medals for all recipients will be formally conferred at the academy’s annual meeting in Canberra on 29 October.

Colleagues say it’s her approach grounded in bold thinking, strong teamwork and community engagement that has seen her recognised.

It hasn’t been easy. Professor Marques’ own journey through ovarian cancer was difficult, but fundamentally transformed her approach to research.

She says she’s determined to lead healthy and well-supported research teams that can bring their whole and best selves to work, and provide the community with holistic yet science-based information and treatments for hypertension.

Lens spoke to Professor Marques about her work.

When everything changed

“In 2015, I was transitioning between my first and my second postdoctoral training when I was diagnosed with stage three ovarian cancer, at just 31 years of age. It was terrifying.

“Most people aren’t familiar with the statistics – only one in three women survives the five years following their diagnosis, and many die over the next five to 10 years. I’ve just reached the 10-year mark past my diagnosis, and for this I’m incredibly grateful.

“My cancer diagnosis played a substantial role in shifting the way that I see the work that I do, not just in terms of my research, but also in leadership and the type of culture I want us to build in medical research.

“As a discovery scientist – a geneticist – my skill set was primarily lab-driven. I’ve realised that we invest time and effort into driving research that may or may not make an impact on someone’s life and health, yet in the pursuit of our research, we’re so often willing to sacrifice not only our own health, but the health of our teams. I realised this wasn’t the culture I wanted to be part of, or create for my team.

“I’m in a privileged position as a laboratory head. I’m in the position where I can choose the research we focus on, who joins the team and with whom we choose to collaborate.

“I’m able to determine these critical variables that ensure that I love my job and am very happy with the work that I do. We’re trying to solve really complex problems, such as understanding how blood pressure is regulated and how to bring global rates of hypertension down. These aren’t problems that just one person or one skill set can solve.

“To achieve this, we need our researchers and teams to feel they can bring their whole selves to work, and for that, psychological safety is key.

Leadership and culture

“The best science is conducted in spaces where people feel safe to ask bold questions. As scientists, our job is to form hypotheses and test them out, and many times, they’re not quite right. Sometimes, they’re entirely wrong, which allows us to move on and find the correct hypothesis faster.

“If we don’t have safe environments, it’s hard to narrow down the right questions to ask, and people won’t feel comfortable putting their hand up to say, ‘I disagree, I don’t think this will work,’ or, ‘I have an idea that might be completely wrong, but if it’s right, it could change everything.’

“I’m fortunate to have enjoyed a fantastic team of mentors. This is precisely what has enabled me to have bold ideas and the freedom to pursue them, and why I’m passionate about my team members and other researchers having the same opportunity.”

Big, bold ideas

“Discovering that the gut microbiome plays a role in hypertension began with my mentors. In 2017, my former lab head at the Baker Institute, Professor David Kaye, met Professor Charles Mackay at an immunology conference, where they discussed the role of dietary fibre in preventing asthma, an inflammatory disease. David brought the idea back to the lab, with an interest in the heart phenotype.

“Being a molecular geneticist, I was very curious and driven to answer the question: How does dietary fibre improve blood pressure and heart function?

“A key element in answering this question was examining the gut microbiome and its potential impact on molecular changes in the heart and kidneys.

“I spent countless hours teaching myself to code, as at the time, very few people in Australia knew how to study the microbiome. I still remember the moment when I got it to work on a Saturday night, sitting on my couch!

“This resulted in a key piece of evidence for our first big paper published in 2017, which has been fundamental to my career trajectory. What started as an idea and a side project has turned into a huge, transformative body of work.

“The whole theory is that we don't have enzymes in the small intestine that digest fibre. So, the fibre passes through the stomach and the small intestine, without ever being digested, reaching our large intestine intact. The large intestine is where we have the most microbes in our body.

“When fibre reaches our large intestine, the bacteria that live there can ferment certain types of fibre, so they basically eat the fibre for us. When they do this, they release substances called short-chain fatty acids that are byproducts of the process.

“What we showed was that fibre was able to lower blood pressure by producing these short-chain fatty acid byproducts. We’d previously had evidence that fibre lowered blood pressure; the first evidence of this came from a 1979 study, and four decades later, our team discovered how it happened.

“My team has now devised a comprehensive map of how these short-chain fatty acids interact with our body to lower blood pressure, by way of a series of receptors that the short-chain fatty acids bind to and activate in our immune cells, which then helps lower blood pressure.

Listening to patients

“We received a grant from the Heart Foundation to run a clinical trial. We tested delivering high levels of short-chain fatty acids bound to fibre, meaning it gets delivered directly into the gut. We were able to prove that short-chain fatty acids indeed lowered blood pressure to a level that was similar to taking one blood pressure-lowering medication.

“We’ve since received a grant from the Australian Stroke and Heart Research Accelerator to develop a prototype of a new supplement product, with the hope of taking it all the way to the commercialisation stage.

“Developing a non-pharmacological option, such as a supplement, was an idea that came straight from the community.

“We’re now running our fifth clinical study, so we communicate with people with high blood pressure all the time.

“We also have an engaged team of consumers that supports our research. They frequently told us that they didn’t want to take medication to manage their blood pressure, particularly the women.

“Women tend to have more side-effects and tend to have less well-controlled blood pressure. They kept saying: ‘I would love just to take a supplement – if you can produce something evidence-based that lowers my blood pressure and isn’t a drug, I’ll take it.’

“So that’s what we’re doing. Evidence-based science is something that became very important to me during my cancer treatment when I was vulnerable and searching for answers. Given that so much of my research is funded by taxpayers through government bodies, or by philanthropic donations, it’s important to me to provide evidence-based information back to the community, and be guided by their concerns and needs.”

Visibility and recognition

“Winning the Jian Zhou Medal means a lot. It’s giving recognition and visibility to the work our whole team – researchers, students, collaborators and consumers – has been focused on for a decade.

“It’s also confirmation of our approach in tackling cardiovascular disease in ways that aren’t necessarily traditional. I’m also proud to put microbiome research in the spotlight and raise awareness that research in this area really does have the potential for translational and community impact.

“Finally, we wouldn’t have got this far as a team if we didn’t have the right culture in place, where people feel safe to do their best work, and for that, I’m most proud.”