#407 ‒ Preventing cardiovascular and Alzheimer's disease: lowering LDL early, APOE4, and promising new therapies | Michael Davidson, M.D.

Early intervention in lipid management is essential for primordial prevention, as maintaining low LDL cholesterol throughout a lifetime significantly reduces cardiovascular risk. Obicetrapib, a novel and potent CETP inhibitor, represents a significant advancement by effectively lowering LDL and Lp(a) while potentially reducing diabetes risk. Beyond cardiovascular health, lipid-modifying therapies are being investigated for their role in Alzheimer’s prevention, particularly in APOE4 carriers, where impaired cholesterol efflux and toxic sterol accumulation contribute to neurodegeneration. The discussion emphasizes the limitations of current high-dose statin paradigms and the necessity of combination therapies to address residual risk. Furthermore, the potential for novel DHA delivery mechanisms, such as lyso-PC forms, offers a promising pathway for improving brain health, highlighting the shift toward more precise, mechanism-based interventions in both cardiology and neurology.