No cognitive effects seen after years of very low LDL cholesterol
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- Reviewed by Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing
Having an extremely low LDL level from aggressive cholesterol-lowering therapy was not associated with cognitive impairment, according to a new study. The study was an extension of an earlier investigation of people with heart disease that compared the cognitive effects of taking the cholesterol-lowering drug evolocumab (Repatha) plus a statin to taking a statin only. That study found no difference in cognitive function between the two groups after a median follow-up of 19 months.
The new study, published in the January 2025 issue of NEJM Evidence, included 473 people from the original report. Those taking only a statin started taking evolocumab as well, while those already taking evolocumab and a statin continued taking both drugs.
With treatment, their LDL cholesterol values ranged from 21 to 55 milligrams per deciliter (mg/dL). (The recommended LDL goal for people with heart disease is less than 70 mg/dL.) Participants had yearly cognitive tests during the median follow-up period of 5.1 years. At the final study visit, cognitive function test scores were similar among all the participants.
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About the Author
Julie Corliss, Executive Editor, Harvard Heart Letter
About the Reviewer
Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing
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