# Cholesterol treatment cuts artery plaque by 20%, highlighting cardiovascular prevention market

By John Kim

Canonical URL: https://www.tokenpost.com/news/insights/48535
Published: 2026-11-04T14:02:19.000Z
Updated: 2026-11-04T14:02:19.000Z
Section: Insights & Views

> Intensive cholesterol treatment cut coronary artery plaque by about 20% over 18 months. Andreessen Horowitz sees opportunities in connecting testing with personalized cardiovascular prevention.

Intensive cholesterol treatment reduced plaque in heart patients’ coronary arteries by about 20% over 18 months. The finding adds to evidence supporting earlier detection and treatment of cardiovascular risk before a first heart attack.

In its “The State of Longevity” report published on November 3, 2026, Andreessen Horowitz said a study published in October showed that reduction. Heart disease remains the leading cause of death in America, but evidence is growing that early detection and medication can help prevent disease and reverse some arterial plaque, the newsletter said.

The report said evidence increasingly supports lower levels of low-density lipoprotein, or LDL, cholesterol, particularly for higher-risk patients. A result within the normal range may still leave risks that warrant additional treatment. In a study of people with diabetes but no known major artery disease, adding Repatha to existing treatment reduced the estimated five-year risk of a first heart attack, stroke or death from coronary heart disease by 31%.

PCSK9 inhibitors such as Repatha help the liver clear LDL from the blood, but injections, costs and insurance restrictions have limited their use, according to the newsletter. Only 21% of its survey respondents knew about the drugs. Lipfendra, the first PCSK9 inhibitor available as a daily pill, received FDA approval in July 2026. Andreessen Horowitz expects wider consumer awareness of these treatments, citing their cholesterol-lowering effects and few side effects.

The report identified lipoprotein(a), or Lp(a), as the next area of interest. Roughly one in five people has elevated levels of this inherited heart disease risk factor, which diet and exercise largely do not affect. U.S. guidelines recommend testing at least once in adulthood, but the cardiovascular benefits of lowering Lp(a) with medication still need to be demonstrated. Novartis’s recent pelacarsen trial lowered Lp(a) but failed to meet its primary endpoint of reducing cardiovascular events. The newsletter remained optimistic about other treatments in trials from Eli Lilly and Amgen.

Andreessen Horowitz said Lp(a) testing can already inform how aggressively other cardiovascular risks are managed, with LDL targets and medication decisions guided by family history and individual risk. It identified a business opportunity for companies that connect testing with personalized treatment, improve access to medication and track patients’ progress.