What is high cholesterol?
Cholesterol is a fatty substance that’s produced by your liver and used by the cells in your body for their normal day-to-day functions. Cholesterol is attached to different proteins that carry it around the body. These proteins determine where it goes and what it does – they also determine the difference between what we call ‘good’ and ‘bad’ cholesterol.
Although cholesterol is essential for our bodies, having too much ‘bad’ cholesterol in your blood significantly increases your chances of developing heart and circulatory diseases and potentially having a heart attack or stroke. This is because cholesterol contributes to the build-up of fatty plaque in the arteries that supply blood to our heart and brain.
Find out more about the symptoms and causes of high cholesterol.
Finding alternatives to statins
Statins are prescribed to millions of people in the UK to help lower cholesterol and are a safe and effective treatment for most people. But we’re also funding research into alternative ways to reduce bad cholesterol, to help even more people lower their risk of developing heart and circulatory diseases.
Dr Endre Kiss Toth and his team at the University of Sheffield are investigating a natural cholesterol-cutting protein in the liver, called tribbles-1. The liver doesn’t usually maintain high levels of tribbles-1, because its production is hampered by molecules called microRNAs. The Sheffield team are attempting to block these microRNAs to see if this can give tribbles-1 the chance to accumulate and control cholesterol levels in a new way.
An antioxidant approach
Atherosclerosis is a condition that develops when fatty plaque builds up on the inside of an artery. During this process, a type of bad cholesterol - LDL cholesterol - invades the inner wall of the artery and undergoes a process called oxidation, which then inflames the artery and encourages plaque development.
Researchers have attempted to prevent or reverse this damage using antioxidants, but the results of clinical trials have been disappointing so far.
At the University of Reading, Dr David Leake and his team have discovered oxidation of LDL cholesterol can take place inside spherical spaces – called lysosomes - within immune cells called macrophages, which accumulate within fatty plaques. One antioxidant drug, cysteamine, can accumulate in lysosomes, so could be effective at reaching and stopping LDL oxidation.
In an exciting development, Dr Leake has seen that cysteamine seems to prevent atherosclerosis in mice. Now, with BHF funding, he’s able to take these findings forward. He’s working to decipher the exact effects of cysteamine on arteries in mice, including seeing if it can prevent pre-existing artery disease from getting worse. This essential groundwork will reveal if this antioxidant could be a candidate for a vital new medicine to protect against heart attack and stroke.
Read about some of the other research we’re funding into atherosclerosis.
New understanding of fatty substances in the blood
The risk of atherosclerosis increases when there are high levels of ‘bad’ cholesterol and fats called triglycerides in the blood. However, the roles of these fatty substances, and their effects on our arteries, is complex - we still don’t understand everything about them.
We’re funding a programme of research, led by Kings’ College London BHF Professor Manuel Mayr, to build the most detailed picture of fatty substances in the blood fats yet. Using state-of-the-art approaches, his team are studying the important molecules that bind to cholesterol and fat in our blood and influence their behaviour. They’re investigating how cholesterol and fats invade the artery wall, so we can find ways to remove them, and are working towards developing a definitive test for them that could predict a heart attack or stroke before it happens.
The difference we’ve already made
Cholesterol-lowering statins have played a major role in our mission to save more lives from heart disease over the past two decades – and our research has been central to the statins story.
BHF Professor Rory Collins at the University of Oxford led the Heart Protection Study – funded by the BHF and the Medical Research Council – which showed the benefit of statins in people at high risk of coronary heart disease. The trial followed over 20,000 volunteers over five years and showed that statins cut the risk of life-threatening heart problems by nearly a quarter. Now they help millions of people stay heart-healthy.
Your donations have also funded enormous advances for families with an inherited condition that causes dangerously high cholesterol from a young age, called Familial Hypercholesterolaemia (FH). With BHF support, Professor Steve Humphries and his team at University College London have pioneered the roll-out of a DNA test that can find people with the condition, so they can be offered treatment before it’s too late.
Read more about our successes in high cholesterol research.