ChemRxiv · Jun 9, 2026

Cholesterol Lowering Medications and Brain Function Evaluating the Link Between Lipid Management and Cognitive Impairment: A Short Review

By Mohammed DH

Cardiovascular diseases are recognized as the leading cause of mortality worldwide, so lipid management is established as a cornerstone of preventive medicine. Because the brain is known as the most cholesterol-rich organ, a "Heart-Brain Paradox" is created when blood cholesterol is aggressively lowered. In 2012, a safety label change was mandated by the FDA due to reports of memory loss and confusion among statin users. In this review, the connection between medications like statins, PCSK9 inhibitors, and ezetimibe and cognitive function is evaluated. It is understood that lipophilic statins can pass through the blood-brain barrier, while hydrophilic statins are generally excluded. Additionally, the potential impacts of pharmaceutical excipients and environmental pollutants on the gut-brain axis are explored. It is concluded that the benefits of vascular protection are generally found to be much greater than the risks of cognitive impairment.

doi.org/10.26434/chemrxiv.15004500/v1Open accessInterventions