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ensuring a low fat, high fibre diet is adhered to;

maintaining a suitable body weight, whilst

having regular exercise; and stopping smoking.

There are also a number of medical

prescriptions that can be given to help further

reduce the chance of developing CVD,

particularly if the risk is high. Such efforts

include blood pressure tablets, for example

angiotensin-converting enzyme (ACE) inhibitors,

which can be used to treat high blood pressure.

Another possibility is the use of statins, which

can help to reduce blood cholesterol levels.

Finally, low-dose aspirin can assist in the

prevention of blood clots.

Lowering cholesterol

In May, the European Medicines Agency (EMA),

an organisation of the EU, announced that it

was recommending the authorisation of

Repatha (evolocumab) as a treatment to lower

high levels of cholesterol in the blood of people

who are unable to control it themselves despite

taking optimal doses of statins, or for people

who are unable to take statins.

The EMA said Repatha should be used in

addition to a healthy diet, and that other

lipid-lowering therapies, such as statins,

should also be used if tolerated. It is also

indicated that Repatha can be used to

treat people with homozygous familial

hypercholesterolaemia, a rare inherited

disorder in which levels of LDL-cholesterol,

known as ‘bad cholesterol’, are higher than

normal from birth. Repatha is intended for

injection under the skin either once every two

weeks or once a month. The marketing

authorisation applicant for Repatha is by

Amgen Europe BV, based in the Netherlands.

Repatha is the first monoclonal antibody, a type

of protein, in this therapeutic area and provides

a new treatment option for patients who are

unable to control a high cholesterol level

despite taking currently available therapies.

Repatha blocks the PCSK9 protein, which

would otherwise lower the number of LDL-

receptors in the liver, and through this


ccording to the European Commission, cardiovascular disease

(CVD) is one of the highest causes of death in the EU – two

million people die each year as a result of such conditions. The

financial cost is also significant, costing the Union’s economy nearly

€110bn a year, as well as having negative effects on the labour market

and long term sickness.

The cardiovascular system relates to the organ system allowing the flow

of blood around the body. Yet blood clots, known as thrombosis, and the

accumulation of fatty deposits within arteries (leading to artery hardening

and narrowing, known as atherosclerosis) can lead to the development

of CVD.

CVD can be split into four main categories. Coronary heart disease occurs

when there is a blockage or reduction of the flow of oxygen-rich blood

to the heart as a result of atheroma in the coronary arteries. Stroke occurs

when the blood supply to a part of the brain is prevented. Another CVD

is peripheral arterial disease, which occurs when there is a blockage in

the arteries to your limbs. Finally, aortic disease, the most common type

being aortic aneurysm, which occurs when the aortic wall becomes

weakened and bulges outwards.

The risk of developing CVD is heightened by several factors including

high blood pressure (known as hypertension) smoking, diabetes, high

blood cholesterol, and a lack of exercise. Other contributing elements

include being overweight or obese, having a family history of heart

disease, the consumption of alcohol, and how an individual deals

with stress.


A number of steps can be taken to help reduce the risk of CVD and thus

keep a healthy heart. Steps EU citizens can take include limiting the

amount of alcohol consumed each week to recommended allowances;


H O R I Z O N 2 0 2 0 P R O J E C T S : P O R TA L


C A N C E R & C A R D I O V A S C U L A R D I S E A S E

The biology of CVD


explores cardiovascular biology, the authorisation of Repatha by the

European Medicines Agency as a treatment to lowering high levels of

cholesterol, and the role of Horizon 2020

Keeping the heart

healthy is important in

preventing CVD