Providence Research Profiles: Dr. Gordon Francis

Dr. Gordon Francis, Principal Investigator with the Centre for Heart Lung Innovation (HLI), is the inaugural recipient of the Beedie Family Professorship in Cardiovascular Disease Prevention. This appointment will support his vital research into the role of cholesterol metabolism in the development of atherosclerosis, and into potential treatments that could help prevent heart attacks and stroke.  

He is the former Director of the Healthy Heart Program Prevention Clinic at St. Paul’s Hospital, which focuses on managing inherited lipid disorders and other cardiovascular risk factors, as well as a Professor in the Department of Medicine, Division of Endocrinology and Metabolism, at the University of British Columbia (UBC).

Education led to interest in lipid and cholesterol metabolism

Originally from Vancouver, Dr. Francis completed a degree in Biochemistry at Simon Fraser University, received his medical degree at McGill University, and trained in Internal Medicine at UBC, based at St. Paul’s Hospital.  

After choosing endocrinology as his sub-specialty, Dr. Francis became interested in lipid and cholesterol metabolism. He completed a fellowship in Endocrinology and Metabolism at the University of Alberta and a four-year research and clinical fellowship at the University of Washington.

He joined iCAPTURE, now the Centre for Heart Lung Innovation, in 2007. He served as Director of the Healthy Heart Program Prevention Clinic from 2007 to 2020, and as the Associate Director of the HLI from 2012 to 2020, alongside Drs. Keith Walley and Tillie Hackett. Today, he continues his groundbreaking research at the HLI as a Principal Investigator.  

Research into the cause and treatment of atherosclerosis 

Atherosclerosis, a hardening of the arteries, occurs when cells accumulate cholesterol and develop into plaques along the artery wall. Heart attacks and strokes caused by atherosclerosis are a leading cause of death internationally.  

“Cholesterol is an interesting molecule, in that most cells in our body make it, but the human body doesn’t have a way to break it down,” says Dr. Francis. He leads research into how to remove excess cholesterol from the artery wall for the prevention and treatment of atherosclerosis.

Much of Dr. Francis’s work is enabled by explanted hearts donated to the Bruce McManus Cardiovascular Biobank, one of the largest cardiac biobanks in Canada. With these samples, Dr. Francis studies which cells accumulate cholesterol and why.  

He and his team have discovered that in coronary arteries, where blockages leading to heart attack and stroke most commonly occur, cholesterol is mainly deposited in the smooth muscle cells, instead of in macrophages, as was previously believed. They are now testing methods to improve the removal of cholesterol from these cells by increasing levels of a key cholesterol-exporting enzyme.  

“We have good preliminary data that if we give the smooth muscle cells more of that enzyme, a lot less plaque will form,” says Dr. Francis.  

Whereas current treatments for high cholesterol disrupt the flow of new cholesterol into the artery wall, this research could lead to therapies capable of reducing existing plaque, lowering the risk of dangerous blockages.  

Prevention clinic improves outcomes for patients with inherited high cholesterol

Another significant aspect of Dr. Francis’ research regards inherited high cholesterol, a condition known as familial hypercholesterolemia. Impacting around one in 250 people, it causes a significantly higher risk of coronary artery disease, heart attack, and stroke.  

Text Box 1, TextboxDr. Francis and his team studied the long-term outcomes of patients with inherited high cholesterol who were treated through the Healthy Heart Prevention Clinic. They determined that over a fifteen-year follow-up period, clinic patients had 82% fewer deaths, and 60% fewer heart attacks, compared to patients who were treated in the community.  

A potential contributor to these results is a common misconception, both in the public and the medical community, that high cholesterol is mainly caused by lifestyle choices and can be lowered just by changes to diet and exercise. In fact, most cases of consistently high cholesterol are caused by genetic factors. For these patients, it is not possible to lower their cholesterol to a safe level without medication.

“What we know is that, if you have persistently high LDL [cholesterol], it’s almost always because of inherited tendencies. It’s not because of eating too much fat in your diet, or not exercising enough,” says Dr. Francis.

While it is a well-known risk factor for heart disease that requires long-term treatment, inherited high cholesterol is not routinely tested for. One of the goals of Dr. Francis’s work is to identify those who have inherited high cholesterol from a young age and start them on treatment early, before plaque buildup has begun.  

Inaugural recipient of the Beedie Family Professorship in Cardiovascular Disease Prevention

Since 2019, Dr. Francis has overseen the Beedie Family Fellowship in Lipidology and Cardiovascular Disease Prevention. Funded by the Beedie family, the program trains two fellows each year in the diagnosis and management of lipid abnormalities, enabling them to take that knowledge out into the community and play a role in preventing heart disease.  

Furthering their support of cardiovascular disease research, the Beedie family has created the Beedie Family Professorship in Cardiovascular Disease Prevention, which will be held by Dr. Francis beginning in January of 2026.  

“It’s a real show of confidence in the work we are doing,” says Dr. Francis.

He is grateful to the Beedie family for their support of both the fellowship and the professorship, which comes at a vital time for his work. It will allow his research to continue and expand, particularly once the new St. Paul’s Hospital opens in 2027 and the Clinical Support and Research Centre opens in 2029.  

Transformative impact on cardiovascular science

Dr. Francis’s journey into cardiovascular research was shaped by influential mentors, including Dr. Jiri Frohlich, former director of the St. Paul’s Hospital Lipid Clinic, who inspired him to specialize in this area of medicine.  

“We all meet people, throughout our lives, who steer us or give us the awareness of what we like, and what we may be good at. Meeting Dr. Frohlich was critical in my decision to pursue this area of medicine and disease prevention,” says Dr. Francis.  

Since 2009, Dr. Francis has played a key role in the creation of lipid treatment guidelines in Canada as a member of the Canadian Cardiovascular Society Lipid Treatment Committee, spearheading initiatives to improve screening for cardiovascular risk nationwide.  

“Dr. Gordon Francis has had a transformative impact on cardiovascular science and clinical care,” says Dr. Marshall Dahl, Head of Providence Health Care and UBC’s Division of Endocrinology. “As founder of the Beedie Family Fellowship in Lipidology and Cardiovascular Disease Prevention, he has also built a legacy of mentorship and training for future leaders. We are truly fortunate to have Dr. Francis at Providence Health Care and the University of British Columbia, where his work continues to inspire discovery, excellence, and patient-centred care.”

Through his clinical and research efforts, Dr. Francis’s continues to improve patient outcomes and advance scientific work which helps patients to lower their cholesterol, directly improving their long-term outcomes. He has advanced the understanding of cholesterol metabolism in heart disease and is pioneering methods to treat and prevent it, demonstrating the power of research to advance science while improving lives.