Lowering LDL cholesterol early in life prevents cardiovascular disease more effectively than waiting for symptoms, and emerging evidence suggests CETP inhibitors like obicetrapib may prevent Alzheimer's disease in APOE4 carriers by improving brain cholesterol metabolism. This episode explores how targeting causal disease drivers regardless of time horizon, the 25-year history of failed CETP inhibitors, obicetrapib's cardiovascular benefits, its unprecedented 50% LP(a) reduction, and its potential to prevent Alzheimer's through mechanisms independent of amyloid-focused therapies. Lowering LDL throughout life using any mechanism produces proportional cardiovascular risk reduction; the formula is consistent across statins, PCSK9 inhibitors, and CETP inhibitors, confirming LDL causality regardless of how it's lowered.