You probably know someone who was considered low risk for a heart attack and still had one. Many heart attacks happen in people whose risk score looked low or moderate. I meet people like that quite often, and when I look back at their records, I usually find untreated high LDL cholesterol. We have excellent treatments that lower the risk of a heart attack, and many more people could benefit from them. I started Preval Health to make these medicines easy to get.
Studies point the same way. Many people with heart disease are still above their LDL goal years into treatment.
Several things get in the way. Guidelines keep changing, and busy clinics have a lot to track. Some risks stay hidden until someone looks, like a high Lp(a), an inherited cholesterol particle, or plaque that only a scan can show. And some people would rather not take another daily pill.
High cholesterol also doesn't cause symptoms, so it rarely feels urgent. Taking a medicine every day for a number you can't feel can seem pointless. Years later, it can show up as a heart attack, a stroke or fewer good years.
In my experience, time is the biggest obstacle, because most of us are busy. Getting treated can mean time off work, a trip to the office, a wait, labs, a follow-up visit and sometimes an insurance appeal.
The treatments work. In large trials, the lower people took their LDL, the fewer heart attacks and strokes they had, and in imaging trials, lowering LDL a lot slowed plaque growth and shrank plaque in many people. Treatment also costs much less than it used to. The newer cholesterol medicines cost about $14,000 a year when they came out. Today they start at about $2,400 a year at cash prices (October 2026), and generic statins and ezetimibe cost far less.
At Preval Health, you sign up online and meet a licensed clinician from our partner network by video. We order your labs at a lab near you. If treatment is right for you, your clinician prescribes it at a cash price, and we continue to follow you to reach your goal and keep you there. Most of it happens online, so you skip the waiting room and the drive. I write the protocols our clinicians follow, based on current guidelines and trials.
If someone you love had a heart attack too young, or your LDL has been elevated for years, ask your doctor, or us, three questions: What should my LDL goal be? Have I had my Lp(a) checked? What would it take to reach that goal this year?
Be there for the good years.
Kaustubh Dabhadkar, MD, MPH, FACC
Founder, Preval Health. About our team
Sources: Cannon et al. (GOULD), JAMA Cardiology, 2021; Singh et al. (YOUNG-MI), JACC, 2018; Cholesterol Treatment Trialists' Collaboration, The Lancet, 2010; Nicholls et al. (GLAGOV), JAMA, 2016; Räber et al. (PACMAN-AMI), JAMA, 2022; Nicholls et al. (HUYGENS), JACC: Cardiovascular Imaging, 2022. Launch prices: Repatha and Praluent US list prices, 2015. Prices as of October 2026.