Vascular Intervention Strategies Trial for Alzheimer's

Inclusion Criteria: * APOE ε4 carrier (homozygote or heterozygote) * LDL-C of 100-250 mg/dL * Systolic blood Pressure (SBP) 130-180 mm Hg * Age 50-75 years * Fluency in English * No dementia based on medical record review * Male or post-menopausal female Exclusion Criteria: * One minute standing SBP \< 110 mm Hg * Arm circumference prevents from accurate BP measurement with use of available devices * Lost weight of \> 10% unintendedly (within the past 6 months), * Contraindications to blood pressure and cholesterol lowering medications * Use of medications prescribed for dementia (e.g., aducanumab, donanemab, lecanemab, donepezil, galantamine, rivastigmine, memantine) * Evidence of dementia based on medical record review * Living in a skilled nursing or rehabilitation facility * Receiving palliative or hospice care * Bipolar illness or schizophrenia * Drug or alcohol disorder * Receiving chronic opioid therapy * Any significant neurological disease (e.g., Parkinson's disease, amyotrophic lateral sclerosis, or multiple sclerosis) * Severe loss of visual, hearing or communication ability * Organ transplant * History of stroke, symptomatic HF or left ventricular ejection fraction \< 35% * ESRD or eGFR \< 20 ml/min /1.73m2 * Does not consent to be contacted or to have their medical record reviewed for research purposes * Concurrent participation in another clinical trial