Heart disease remains the world’s biggest killer and continues to affect millions of families every year. In the United States, about one in every four deaths is linked to heart disease.
One of the most common forms is coronary artery disease, a condition in which the arteries that supply blood and oxygen to the heart gradually become narrow or blocked. This usually happens because fatty deposits, known as plaque, slowly build up inside the blood vessels over many years.
As the arteries become narrower, less blood reaches the heart muscle. If a plaque suddenly breaks open, a blood clot can form and completely block the artery, causing a heart attack. Because of this, scientists around the world are working hard to understand exactly how plaque forms and why it sometimes becomes so dangerous.
A recent study from the University of Virginia Health has uncovered an important clue that may one day lead to new ways of preventing or treating coronary artery disease.
Instead of focusing only on cholesterol or blood pressure, the researchers investigated the behavior of special cells found inside the walls of blood vessels. Their findings were published in the journal Circulation: Genomic and Precision Medicine.
The cells they studied are called smooth muscle cells. These cells normally help blood vessels stay strong and flexible so blood can flow properly. However, scientists have learned that these cells can also play two very different roles during heart disease. In some situations, they help protect the body by forming a strong cap over plaque inside the artery.
This protective cap makes the plaque less likely to burst, reducing the risk of heart attacks and strokes. At other times, however, the same cells begin acting differently and actually help plaque grow larger. For years, researchers have been trying to understand what causes this surprising change.
To answer this question, doctoral student Noah Perry worked with his mentor, Dr. Mete Civelek, at the University of Virginia School of Medicine.
Using smooth muscle cells collected from heart transplant donors, the researchers carefully studied which genes were active inside these cells. By examining how the genes behaved, they hoped to discover what causes healthy, protective cells to become harmful.
Their research pointed to two important areas: nitrogen and glycogen metabolism. Glycogen is the form in which the body stores sugar for later use as energy.
The researchers believe that changes in the way smooth muscle cells process nitrogen and glycogen may push the cells toward harmful behavior. Although scientists still need to understand the exact process, this discovery offers a new direction for future research.
The team also became interested in a natural sugar called mannose. Their results suggest that mannose may influence how smooth muscle cells change their behavior. At this stage, researchers cannot say that mannose directly causes the problem, but they believe it deserves much closer investigation.
Future studies will examine whether changing the way these cells use mannose could help stop plaque from growing or make blood vessels healthier.
This discovery is exciting because current treatments for coronary artery disease mainly focus on lowering cholesterol, reducing blood pressure, preventing blood clots, and encouraging healthier lifestyles.
These treatments save many lives, but they do not directly control how smooth muscle cells behave inside artery walls. If scientists learn how to keep these cells in their protective state, they may be able to develop completely new treatments that work alongside today’s medicines.
The research team, including Dr. Civelek, Diana Albarracin, and Redouane Aherrahrou, plans to continue studying these cells to better understand the biological changes taking place. Their goal is to identify new treatment targets that could eventually reduce plaque growth and lower the risk of heart attacks and strokes.
While this research is still in its early stages, there are already many proven ways to protect heart health. Eating a balanced diet rich in fruits, vegetables, whole grains, beans, fish, and healthy fats can help reduce the risk of heart disease. Regular physical activity strengthens the heart and improves blood circulation.
Maintaining a healthy body weight, avoiding smoking, controlling blood pressure and cholesterol, managing diabetes, getting enough sleep, and reducing long-term stress are also important steps. Some research also suggests that nutrients such as vitamin D and vitamin K may support heart health, although more studies are needed to fully understand their roles.
This new study provides a fresh look at what happens inside our blood vessels and offers hope that scientists are getting closer to understanding the hidden processes behind coronary artery disease.
Although more research is needed before these findings can be turned into treatments, the discovery opens an exciting new path that could one day help millions of people live longer and healthier lives.
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The study was published in Circulation: Genomic and Precision Medicine.
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