In a recent review study, researchers have proposed a unique treatment in humans to reduce the early onset of atherosclerosis, the buildup of the artery-clogging plaque that can lead to heart attacks and strokes.
The report reviews a host of previous research and proposes a new clinical trial to reduce apolipoprotein B, also called apo B lipoproteins, in young and middle-age adults.
If this works, people could completely eliminate heart attacks and strokes within a generation, because they can’t have a heart attack or stroke unless they have atherosclerosis.
The study was done by researchers at the University of Iowa.
Over the past few decades, research has pointed to this group of blood proteins, which includes LDL, or “bad cholesterol,” as the main culprit in the beginnings of atherosclerosis.
The proposed trial, CURing Early ATHEROsclerosis, or CURE ATHERO, would set out to determine if atherosclerosis in high-risk adults aged 25 to 55 might be reversed by using medicines called statins and PCSK9 inhibitors over the course of three years.
The idea is to get the cholesterol very low for a short period of time, let all the early cholesterol buildup dissolve, and let the arteries heal.
This approach has worked well in animal studies.
Then patients might need to be retreated every decade or two if the atherosclerosis begins to develop again.
Lipoproteins are tiny, complex particles that transport fat and cholesterol through the blood.
Other researchers not involved in the study called the proposal a “very compelling idea” that might show whether older adults can avoid heart attacks and strokes by making sure they have low LDL and apo B levels earlier in their lives.
It is known that people who have low LDL cholesterol for genetic reasons have a very low risk of having cardiovascular events.
If scientists can replicate one of these genetic states and get people’s LDL cholesterol really low in early adulthood, perhaps these people won’t have downstream complications like heart attack and stroke.
The proposed trial would face certain challenges, including reluctance among young, seemingly healthy adults to take medicatio. Another possible obstacle is the length of the study.
Atherosclerosis develops over decades. It’s going to be very difficult to conclusively link a treatment strategy in people in their 30s or 40s to a reduction in risk 20 or 30 years later.
Doctors aren’t currently advised to test patients’ apo B levels, because routine LDL cholesterol tests and other measures already give doctors information to assess cardiovascular risk.
But the team hopes the proposed trial will show that lowering apo B levels early in life will help people who are genetically inclined to have high cholesterol, as well as those with health problems caused by a poor diet, obesity and lack of exercise.
A clinical trial could pave the way for a new generation of therapies to fight heart attacks and strokes.
The report is published in the Journal of the American Heart Association.
Copyright © 2018 Knowridge Science Report. All rights reserved.
Source: Journal of the American Heart Association.