What is atherosclerosis?
Atherosclerosis is the build up of a fatty material called plaque in the walls of your arteries. Over time, this plaque causes the insides of your arteries to narrow, limiting blood supply to vital organs like the heart and brain, which can cause more serious problems. If a piece of plaque ruptures, it can cause a blood clot to form and block the blood supply to parts of the heart or brain, which is a major cause of heart attacks and strokes.
Atherosclerosis is a silent process, which develops over many years. Most people won’t know they have it until they experience a heart attack, stroke or angina (a type of chest pain caused by insufficient blood supply to the heart muscle).
Learn more about the causes, symptoms and treatments for atherosclerosis.
Predicting how plaque will react
Dr James Rudd at Cambridge University is attempting to improve the way we visualise the formation of atherosclerotic blood vessels using positron emission tomography (PET) scans - these are a way of imaging the body already widely used in hospitals. He hopes to develop a new method that will allow PET to be used to predict if plaque is at risk of rupturing, to see if someone is in danger of suffering from a heart attack or stroke, before it occurs.
Harnessing your immune system to fight atherosclerosis
BHF Professor Ziad Mallat at the University of Cambridge is studying how blood vessels are affected by atherosclerosis to see if there is a way of preventing them becoming inflamed.
When plaque builds up in our arteries, our immune system recognises it as a foreign material. White blood cells called T lymphocytes are activated, and the blood vessel becomes inflamed. Some T lymphocytes subsets promote atherosclerosis and some subsets protect against it.
Professor Mallat is using state-of-the-art genetic studies to identify the specific cells that instruct the T lymphocytes to react aggressively in atherosclerosis and make the disease worse. This research will lead to a better understanding of how the immune system reacts against the deposited cholesterol in our arteries. It could even show us how to control the immune system to protect against atherosclerosis.
The difference we've already made
The biggest success story for preventing atherosclerosis is undoubtedly statins. These are drugs used to lower blood cholesterol, a major risk factor for atherosclerosis. Since the 1980’s, research has shown giving statins to people with high cholesterol, or those at risk of developing it, is a safe and effective way of reducing their chances of suffering from of a heart attack or stroke.
One of the most important trials was the Heart Protection Study, which we funded together with the Medical Research Council. This trial of over 20,000 people showed reducing the levels of ‘bad’ LDL-cholesterol resulted in having fewer heart attacks and strokes. Importantly, the study showed that for people without particularly high cholesterol, statins were still beneficial.
Statins are now the most commonly prescribed drug given to people at risk of developing heart disease. An estimated 7,000 lives are saved by these drugs in the UK each year.