The Proof with Simon Hill
The Proof with Simon Hill

Superagers, statins, the latest cholesterol pill and the truth about heart disease risk | Dr Terry Simpson

August 4, 2026

AI Summary

5 min read

“We have these people, which gives people like me who are older than you… is you want to maintain your brain as long as you can. And know that genetics is not your fate in terms of that is, I think, remarkable and great.” That’s Dr. Terry Simpson, bariatric surgeon and longtime health commentator, returning to The Proof to talk about superagers, the latest cholesterol drugs, and the truth about heart disease risk. The conversation moves from a surprising study on cognitive resilience in the elderly to the mechanics of plaque, the limits of current imaging, and the business of dietary misinformation.

The superager surprise: genetics is not destiny

A recent study on “superagers”—people in their 80s with brains equivalent to those 20 to 30 years younger—found something unexpected. Researchers expected these individuals to carry protective genetic variants like the APOE2 allele, which lowers Alzheimer’s risk, and to lack the high-risk APOE4 allele. Instead, the distribution of these genes was equal to the general population. Genetics did not explain their cognitive preservation.

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What you'll learn

  • 1 (00:03) **Episode Introduction & Agenda** - Simon Hill welcomes back Dr. Terry Simpson and outlines the episode's format: discussing new science, addressing online misinformation, and reviewing recent studies.
  • 2 (01:28) **The "Super Ager" Genetics Study** - Dr. Simpson shares a recent study on octogenarians with no cognitive decline, finding their brain health was not linked to the APOE gene.
  • 3 (03:59) **The MIND Diet Explained** - Dr. Simpson breaks down the MIND diet, emphasizing progress over perfection and its role in delaying dementia.
  • 4 (07:04) **Oral PCSK9 Inhibitor & Plaque Geology** - Dr. Simpson discusses a new oral PCSK9 inhibitor and uses a volcanic analogy to explain how these drugs stabilize and regress arterial plaque.
  • 5 (14:20) **Personalizing PCSK9 Therapy & Plaque Monitoring** - Simon shares his personal decision to start a PCSK9 inhibitor (Lerodalcibep) and discusses the limitations of CT angiogram plaque analysis.
  • 6 (24:03) **Lowering APOB: The Cumulative Burden Argument** - The conversation centers on why earlier intervention to lower APOB is critical for preventing future heart attacks, even without visible plaque.
  • 7 (28:00) **Why Plaque Forms in Arteries, Not Veins** - Dr. Simpson explains the physiological and anatomical reasons why atherosclerosis occurs in arteries, addressing a common counter-argument.

+ Full timestamped outline available in the app

Guests on this episode

Simon Hill

Show Notes

Dr Terry Simpson is back, and we go deep on the science of protecting your heart and brain for the long run. He is a surgeon and one of the clearest voices online for separating solid evidence from confident hype, and in this conversation we tackle everything from new cholesterol-lowering drugs to gene editing, cognitive ageing, and the lean mass hyperresponder debate.

Along the way we get a few things off our chests about the misinformation that spreads faster than the careful answer ever can.

What We Cover

  • Why healthy ageing brains owe more to lifestyle than to genetics
  • How PCSK9 inhibitors work, and why plaque is more like geology than plumbing
  • Gene editing for cholesterol and functional cures for type 1 diabetes
  • The lean mass hyperresponder debate and what the Keto-CTA re-analysis shows
  • Why colorectal cancer is rising in younger adults
  • The 2026 dyslipidemia guidelines and why you should test your Lp(a) once

This is a grounded, evidence-first conversation, and I hope it helps you feel clearer and more confident about the decisions that actually move the needle. If you enjoy the episode, please take a moment to rate and review the show, it genuinely helps more people find it.

To connect with Dr Terry Simpson, visit terrysimpson.com, where you will find his bio, recipes, and plenty more. You can also follow him on Instagram, X, and TikTok, and read his writing on Substack.

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