Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients.

Podcast Summary

Dr. Warrick is a practicing cardiologist and author dedicated to educating patients about heart health. In this episode, he addresses two common patient questions: how low cholesterol can go without affecting brain function, and whether statins impair cognitive function. Through examination of clinical trials and natural examples, Dr. Warrick provides evidence-based reassurance about the safety of aggressive cholesterol lowering and statin use for brain health.

Key Takeaways:

• The Ebbinghaus study demonstrated that very low LDL cholesterol levels achieved with PCSK9 inhibitors produced no measurable cognitive impairment, even at levels lower than typically seen after heart attack treatment.

• Newborn babies naturally have very low LDL cholesterol levels (50-70 mg/dL) during their most active period of brain development, suggesting the brain functions well at these low levels.

• Families with non-functioning PCSK9 genes maintain very low cholesterol throughout their lives and show no brain dysfunction or cognitive abnormalities, often living long healthy lives.

• The PROSPER study of nearly 6,000 elderly patients found no difference in cognitive decline between those taking pravastatin and control groups over 3.5 years.

• The Heart Protection Study using simvastatin and the Jupiter trial using rosuvastatin both found no difference in cognitive outcomes between statin users and non-users across thousands of patients.

• Of 12 small trials specifically examining statins and cognition, nine showed no difference, one suggested decline, and two suggested cognitive benefit.

• Some statins are lipophilic (fat-soluble) and may accumulate in brain tissue, while others like rosuvastatin are hydrophilic (water-soluble) and less likely to affect the brain.

• Individual responses to statins vary, and mental fog may result from multiple lifestyle factors; if cognitive concerns arise, switching to less brain-penetrating statin options is a reasonable approach.