Associate feature: Finding the right medication can help us fight cardiovascular disease

Cardiovascular disease is still the biggest killer in Scotland, despite very significant advances in patient care and improvement in medication.

In many cases, the major health issues associated with cardiovascular disease are caused by a blockage of blood vessels due to a build-up of fat in the vessel wall. Most often, this occurs in the heart.

This impacts on the performance of the heart to pump blood and, depending on severity, can be fatal or at the very least have a significant impact on life quality.

In non-fatal cases, the clinical treatments commonly used are either insertion of a metal stent into the blocked blood vessels (to widen the blood vessel opening) or bypass surgery (where another blood vessel, usually from the leg, is inserted to act as a bypass around the blockage).

Although these interventions have dramatically improved life expectancy in cardiovascular disease patients, in around 20 per cent of stent patients a new blockage appears caused by thickening of the blood vessel wall and consequently the centre of the vessel becomes narrower.

This narrowing is called ‘restenosis’ and requires even more complicated treatment with an increased risk to health. Having the right medication to prevent restenosis is therefore an important area in medicine and our research is working towards uncovering potential drugs which could be used in this condition.

Restenosis is caused by the cells in the blood vessel which, in response to metal stent insertion, move from the middle of the blood vessel wall (where they normally reside) to the inside of the vessel. This is known as migration.

These cells subsequently grow on the inner surface of the vessel, leading to narrowing and a decreased blood flow. One target to prevent restenosis is therefore to inhibit the initial migration of the cells in the blood vessel wall.

In our laboratory at the University of Aberdeen, we have used blood vessel cells from cardiovascular disease patients and investigated the migration processes that make these cells move during restenosis.

Our recent research funded by the British Heart Foundation has demonstrated that a drug called ‘beraprost’ specifically blocks these migration processes in blood vessel cells and could therefore potentially inhibit the development of restenosis in patients.

We are continuing further testing of beraprost in the laboratory and this must also be fully evaluated with clinical trials in patients undergoing stent insertion. Importantly, the drug has already been evaluated for use in people, although is not licenced for restenosis. In due course, we hope that it may provide new medication for condition.

Professor Graeme Nixon leads the Metabolic and Cardiovascular Health programme at the University of Aberdeen