Inclusion Criteria:

• 1. Provision of signed and dated informed consent form.
• 2. Stated willingness to comply with all study procedures and availability for the duration of the study.
• 3. At least one Atherosclerotic Cardiovascular Disease (ASCVD) risk factor, such as:
• 1. ≥ 50 years of age
• 2. Hypertension
• 3. Hypercholesterolemia
• 4. Diabetes
• 5. Current or former smoker
• 6. First-degree family history of any cardiovascular heart disease
• 7. BMI \> 25
• 8. On hypertension treatment, statin, and/or aspirin therapy
• 4. Patients with clinically localized prostate cancer. That is Low or intermediate risk prostate cancer defined as:
• 1. Pre-operative PSA (Prostate Specific Antigen) ≤ 20.0 ng/ml
• 2. Clinical stage T1c or cT2
• 3. Gleason score 3+3 or 3+4 or 4+3
• 5. Patients on AS with plans for surveillance biopsy
• 6. No previous treatment for prostate cancer with radiotherapy, chemotherapy, or hormonal therapy
• 7. Ability to take oral medication and be willing to adhere to once daily, oral Vytorin or ezetimibe.
• 8. Agree to avoid consumption of grapefruit and grapefruit juice ≥ one quart per day throughout study duration.

Exclusion Criteria:

• 1. Current use of medications contraindicated for use with a statin such as strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, and nefazodone).
• 2. Current use of medications contraindicated for use with ezetimibe (i.e., gemfibrozil, cyclosporine, or danazol).
• 3. History of allergic or severe reaction to a either study agent.
• 4. History of moderate or severe myalgia with statin use.
• 5. Acute liver failure or decompensated cirrhosis
• 6. Already on maximum VYTORIN dose (10/80)
• 7. Already on a PCSK9 inhibitor