Most of the healthcare costs in the U.S. can be attributed to the treatment of disease after it strikes, particularly for chronic conditions such as cardiovascular disease, obesity, and diabetes. Significant resources are dedicated to understanding the characteristics, causes, and effects of illness, with little left for understanding how the body functions, how we can promote health and turn back disease before it strikes. At Esperion, we believe there are many and varied pathways for impacting cardiovascular and metabolic health that warrant further exploration. We seek to explore, create, and build new pathways to better health. We intend to develop and commercialize biotech therapies that will be able to prevent, treat, and reverse cardiovascular and metabolic diseases.

For example, in the past, cholesterol drug discovery and development efforts were aimed chiefly at therapies designed to lower LDL - the "bad" cholesterol. Esperion was the first to identify and take advantage of the opportunity provided by improving HDL - the "good" cholesterol. Esperion demonstrated that atherosclerosis, a build up of cholesterol and other lipids in the artery walls and a major underlying cause of heart attack, can be rapidly and safely reversed by improving the amount and function of HDL. Esperion pursued this new treatment pathway and other therapies meant to mimic or improve upon HDL function by pulling plaque out of the arteries. We intend to build on that work, continuing to explore a variety of pathways for better lipid regulation to treat the full spectrum of cardiovascular and metabolic diseases, from early risk factors to acute coronary syndromes to regression of atherosclerosis.

Cardiovascular System

The cardiovascular system is comprised of the heart and blood vessels and delivers oxygen and other nutrients to the tissues and organs of the body such as the brain, kidneys and lungs. The cardiovascular system is also able to remove waste products. The heart propels blood through a network of arteries and veins. The kidneys regulate blood volume, and the lungs put oxygen in the blood and remove carbon dioxide. To accomplish these tasks, the cardiovascular system must maintain adequate blood flow, which can be dramatically reduced by the excessive deposit of fats, or lipids, including cholesterol, within the artery walls.

Cholesterol is required for normal cell function and health. Our bodies obtain cholesterol both through the foods we eat and by manufacturing cholesterol inside some of our cells and organs. Cholesterol either remains within the cell or is transported by the blood to various organs. The major carriers for cholesterol in the blood are known as lipoproteins, which are particles composed of fat and protein, including low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL delivers cholesterol to organs where it can be used to produce hormones, maintain healthy cells, or be transformed into natural products that assist in the digestion of other lipids. HDL removes excess cholesterol from arteries and tissues to transport it back to the liver for elimination.

In a healthy human body, there is a balance between the delivery and removal of cholesterol from the blood. Over time, however, an imbalance can occur in our bodies in which there is too much cholesterol delivery by LDL and too little cholesterol removal by HDL. When people have a high level of LDL cholesterol and a low level of HDL cholesterol, there is more cholesterol being deposited in arterial walls than being removed. This imbalance can contribute to cardiovascular disease.

Lipid and Metabolic Disorders

Dyslipidemia refers to any of several lipid abnormalities, including high LDL cholesterol, low HDL cholesterol, or high triglycerides (fats that are not cholesterol). Dyslipidemia affects a significant portion of the world's population and plays an important role in the development of cardiovascular disease. In the case of high LDL cholesterol, the excess cholesterol carried in the blood in LDL particles can be deposited throughout the body and frequently ends up in the arterial wall, especially those found in the heart. As a result, a buildup of plaque can form and narrow the arteries, which may lead to acute coronary syndromes such as acute chest pain or a heart attack.

A lower than normal level of HDL cholesterol is another form of dyslipidemia. This lipid abnormality is just one of a collection of health risks known as metabolic syndrome that increases an individual's risk of heart disease and other conditions such as diabetes and stroke. "Metabolic" refers to the biochemical processes involved in the body's normal functioning - or how cells interact with each other and their environment. Metabolic syndrome is diagnosed when three of five risk factors are present in a patient: low HDL levels, abdominal obesity, elevated triglycerides, high blood pressure, or high blood sugar. A person can develop any one of these risk factors by itself, but they tend to occur together. Experts estimate that 1/4 of the U.S. population suffers from metabolic syndrome. A person with metabolic syndrome is twice as likely to develop heart disease as someone without the condition, according to the National Heart Lung and Blood Institute.

Better regulation of LDL and HDL cholesterol and other lipids in the blood can significantly reduce the risk of developing cardiovascular and metabolic diseases. As a result, the healthcare community is increasingly recognizing the need for a more aggressive approach to lipid management.