Bempedoic acid lowers LDL cholesterol by inhibiting ATP-citrate lyase (ACL), an enzyme upstream of the statin target HMG-CoA reductase. It is a prodrug activated primarily in the liver, which may reduce the muscle-related side effects associated with statins. Its primary healthspan relevance is the significant reduction of atherosclerotic cardiovascular disease (ASCVD) risk, a leading cause of age-related mortality and morbidity.
Verdict
A valuable statin alternative for lowering LDL and cardiovascular risk.
HEALTHSPAN IMPACT
High Value
RISK LEVEL
Moderate
EVIDENCE GRADE
A
MONTHLY COST
$400 - $550
Protocol
- A standard dose is 180 mg taken orally once daily, with or without food.
Flags
- Requires a prescription and medical supervision.
- May increase uric acid levels, potentially triggering gout in susceptible individuals.
- Carries a small but increased risk of tendon rupture.
- Increases blood levels of simvastatin and pravastatin, requiring dose adjustments.