The inner lining of blood vessels should be smooth and unobstructed, but fatty deposits can begin to line the arteries and cause them to fur up, making them irregular and narrower. Over time the fatty deposits can become more calcified and develop into plaques, which are at risk of rupture, the substrate for a heart attack.
Lowering cholesterol has been proven to reduce the risk of heart and stroke and statins, which do just that, are the most commonly prescribed drug in the UK. Statins do not just lower cholesterol, however, they also stabilise plaques in the coronary arteries and make them less likely to rupture. Although the effects of statins on the cardiovascular system are overwhelmingly positive, in some people cholesterol levels do not come down to within recommended limits despite the maximum dose of the drug.
Hope is now on the horizon for these individuals as a new drug called inclisiran, delivered by injection twice a year, has been shown to halve cholesterol in as little as two weeks. This drug has not yet received NICE (National Institute for Health and Care Excellence) approval as it is still undergoing clinical trials, but Novartis, the drug company developing it, has teamed up with the NHS, with the intention of preventing 55,000 heart attacks and strokes in the next ten years.