Which Cholesterol-Lowering Therapy Best Reduces ApoB & Heart Risk? | Simon Hill | The Proof EP #380

Video Description

👇 Visit The Proof website for the full show notes and supporting studies. 👇 https://theproof.com/podcast/ In this episode of The Proof, I’m joined once again by two of the world’s leading lipid experts, Dr Tom Dayspring and Dr Dan Soffer. Together we take a deep dive into the world of lipid-lowering therapy: what these medicines are, how they work, and what decades of clinical trials reveal about their impact on cardiovascular health. From statins and ezetimibe to PCSK9 inhibitors, fibrates, and beyond, we explore the mechanisms, safety profiles, and effectiveness of different therapies. We also cover the nuances of guidelines, primordial prevention, and whether people should consider treatment earlier in life. Along the way, Tom offers a fascinating historical tour through landmark trials, while Dan brings a clinician’s perspective on evidence-based practice and patient care. What We Cover: - What lipid-lowering therapy actually is - Statins, ezetimibe, fibrates, and PCSK9 inhibitors - How these drugs work and who benefits most - Absolute vs relative risk reduction explained - Guidelines vs clinical practice - New therapies and future directions - Lipoprotein(a): risk and emerging treatments - And much more This episode will help you better understand the medicines used to reduce cardiovascular risk and how they fit into the bigger picture of prevention and long-term health. Timestamps: 00:00:00 Intro: What Are Cholesterol-Lowering Drugs and How Do They Work? 00:05:00 How Do Cholesterol-Lowering Medications Lower Heart Risk? 00:09:29 Who Should Start Statins or Other Cholesterol Drugs? 00:22:54 Landmark Cholesterol Trials That Changed Heart Disease Treatment 00:37:35 Do Fibrates Still Matter for High Triglycerides? 00:43:38 Ezetimibe & PCSK9 Inhibitors: Do They Add Benefits Beyond Statins? 00:53:09 CLEAR Outcomes Trial: What It Means for Statin-Intolerant Patients 00:54:52 Bempedoic Acid vs Statins: Effectiveness, Side Effects & Cost 01:02:57 What Do Statin Trials Really Show? Heart Attacks, Death & Risk Reduction 01:13:14 When to Use Low vs High-Intensity Statins (and Add Ezetimibe) 01:16:39 Hydrophilic vs Lipophilic Statins: What’s the Difference? 01:21:25 Do Statins Affect the Brain or Your Body’s Cholesterol? 01:28:16 PCSK9 Therapies Explained: Antibodies, siRNA, Oral Drugs & Gene Editing 01:34:21 What’s the Best Combination Therapy After Statins? 01:36:37 LDL Guidelines Explained: Thresholds vs Goals 01:44:14 The Most Up-to-Date Cholesterol Guidelines (2025) Subscribe and stay connected: Found this episode valuable? Subscribe to The Proof on YouTube and hit the notification bell to stay updated. Listening on Spotify or Apple Podcasts? Follow the show to ensure you never miss an episode. Support the show: The best way to support the show is to use the products and services offered by our sponsors. Visit http://theproof.com/friends for exclusive discounts. If you have any additional questions you would like answered in the future, let me know in the comments. Enjoy, friends. Simon This episode is brought to you by: 38TERA Consider 38TERA's DMN prebiotic supplement a daily multivitamin for your gut. Formulated by yours truly and gastroenterologist Dr Will Bulsiewicz. Head to https://38tera.com/?ref=SIMON and use code THEPROOF for a discount at checkout. Eight Sleep Upgrade your sleep with the Pod 5 Ultra by Eight Sleep. Clinically validated to deliver up to 1 extra hour of quality sleep per night through temperature control and biometric tracking. Use code THEPROOF for $350 off at http://eightsleep.com/theproof. Try it risk-free for 30 days, with worldwide shipping. Bragg Bragg Organic Apple Cider Vinegar is raw, unfiltered, and naturally fermented with 100% organic apples, always with the live “Mother” in every bottle. Get 20% off your first order at http://bragg.com with promo code SIMON. IM8 With 92 nutrients, including Vitamin B12, Iodine, Selenium and Vitamin D, in highly absorbable forms, IM8 Daily Essentials is the perfect all-in-one daily multi-vitamin to ensure you meet your daily micronutrient needs. IM8 is offering an exclusive 10% off your first order with a free welcome kit when you enter the promo code SIMON at checkout on http://im8health.com/ WHOOP Whoop, the most advanced fitness and health wearable available. Your personalised fitness and health coach to recover faster, sleep better, and train smarter. Claim your first month free on http://join.whoop.com/simon Simon Hill, MSc, BSc (Hons) - Creator of http://theproof.com/ - Host of https://theproof.com/podcast/ - Author of https://theproof.com/book/ Subscribe & Connect: - YouTube: https://www.youtube.com/c/TheProofWithSimonHill?sub_confirmation=1 - Apple Podcasts: https://podcasts.apple.com/au/podcast/the-proof-with-simon-hill/id1367773989 - Spotify: https://open.spotify.com/show/7bAIJCVgnquxXZuQCdZyTi?si=84831dc34dc9408b - Instagram: https://www.instagram.com/theproof/ - X: https://x.com/theproof