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Home » Cardiology » Why we won’t accept that high cholesterol is just a part of ageing

Dr Sekar Kathiresan

Co-Founder and Chief Executive Officer, Verve Therapeutics

Dr Andrew Bellinger

Chief Scientific Officer and Chief Medical Officer, Verve Therapeutics

To reduce the risk of heart attacks, the key is to lower the levels of so-called ‘bad’ cholesterol as much as possible for as long as possible. 

Despite what you may have heard or read, high cholesterol — a lipid (or fat) produced in the liver — isn’t just a normal part of ageing. Getting the cholesterol as low as possible for as long as possible is probably the best way to treat as well as avoid a heart attack. 

The big problem is that, due to genetics, lifestyle and/or diet, many of us have far too much low-density lipoprotein cholesterol (LDL-C) — so-called ‘bad cholesterol’ — storing up a time bomb of trouble in our blood vessels. Without treatment, this can lead to atherosclerotic cardiovascular disease (ASCVD), a condition that can have serious and sometimes fatal repercussions. 

“Problems occur when cholesterol starts building up in the walls of our arteries,” explains Dr Andrew Bellinger, Chief Scientific Officer and Chief Medical Officer of genetics medicines company, Verve Therapeutics. “When we’re younger, this is just a sort of fatty smear; but, over time, it can cause inflammation and plaque buildup. If larger, fattier, unstable plaque deposits rupture, they can block an artery. This can lead to a heart attack or stroke, which is the leading cause of death in the world right now.”

People with high levels of LDL-C are more likely to suffer a heart attack.

Dr Sekar Kathiresan

People with low LDL-C are more resistant to heart attack

The statistics are alarming. In England, heart disease accounts for around a quarter of deaths, with 140,000 people dying from the condition each year, according to the NHS. To reverse this trend, it’s crucial to get LDL-C levels as low as possible, for as long as possible, insists Dr Sekar Kathiresan, Cofounder and Chief Executive Officer of Verve Therapeutics.

“People with high levels of LDL-C are more likely to suffer a heart attack,” he says. “Extensive research has shown that we are all probably meant to live with an LDL-C around 1 mmol/L. Those who have naturally occurring DNA variation that keeps their LDL-C low are more resistant to heart attack and ASCVD.

Inefficiencies of the chronic care model for ASCVD

Traditionally, lowering cholesterol has meant taking daily treatment, such as statin medication, often for decades. However, Dr Kathiresan believes this is part of a broken — and expensive — model of chronic care. “CVD-related healthcare costs in England are estimated at £7.4 billion per year,” he says, “with annual costs to the wider economy estimated at £15.8 billion, according to the UK Health Security Agency.”

The fact is that only half of the people who should be taking cholesterol-lowering medication actually do. There are a few reasons for this, but the main one is that the chronic care model of daily pills or intermittent injections over decades places a heavy burden on patients, providers and the healthcare system. 

Treating the disease with a breakthrough one-and-done approach

In what promises to be an exciting breakthrough development for the field of cardiology and cardiovascular disease, Verve Therapeutics is pioneering a new approach to ASCVD with a once-and-done gene-editing medicine designed to durably lower LDL-C after a single intravenous infusion. In animal models, this investigational medicine has been shown to lower LDL-C by up to 70% with durability for more than two years, raising the possibility of a once-and-done treatment for LDL-C and ASCVD.

“There’s a belief that high cholesterol and its associated risks are just a normal part of ageing that we have to accept,” says Dr Bellinger. “We’re saying that it really doesn’t have to be that way. And we won’t accept it. High levels of LDL-C are a leading contributor to heart attack and current treatment options are too burdensome to address a majority of patient needs. A once-and-done treatment has the potential to protect the world from cardiovascular disease.”

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