What if there was a pill that could slash your risk of heart attack, stroke, and death by up to 30%? According to cardiologist Dr. Mike Heffernan, this game-changing medication already exists. The catch? Most people who could benefit aren’t taking it – and many are confused about whether they really need it.
In a recent video discussion with Dr. Paul Zalzel and Dr. Brad Wayne, Dr. Heffernan shed light on the complex world of cholesterol management. From the role of genetics to the promising future of non-statin drugs, he shared crucial insights that could help you advocate for your heart health.
If you’ve ever wondered what to make of your cholesterol numbers, whether lifestyle changes are enough, or why statins are so controversial, this is a must-read. Let’s dive into the key takeaways that could save your life – or the life of someone you love.
Why We Can’t Live Without Cholesterol (But You Can Have Too Much of a Good Thing)
First, the basics: Cholesterol is a waxy substance that’s essential for making hormones, vitamin D, and the walls of our cells. “We can’t survive without cholesterol,” explains Dr. Heffernan. The trouble starts when we have more than our bodies can handle.
About 85% of the cholesterol in your body right now is produced by your own cells, especially in the liver. That balance is largely determined by genetics. Only about 15% comes from your diet – which means even the healthiest eating habits may not be enough to keep levels in check.
When there’s too much cholesterol circulating in your bloodstream, the surplus can sneak into your artery walls and build up into clogs. This is especially true for small, dense particles called LDL, or “bad,” cholesterol.
The Diet and Exercise Prescription That Can Slash Cholesterol by 20%
While you can’t control your genes, lifestyle factors like diet and exercise can move the needle. According to Dr. Heffernan, the average person can lower their cholesterol by about 20% through healthy habits, including:
- Maintaining a healthy weight
- Eating plenty of fruits, veggies, legumes, and whole grains
- Choosing lean proteins over fatty cuts of meat
- Limiting processed foods and added sugars
- Getting regular exercise, like brisk walking, swimming, or cycling
A plant-based or Mediterranean-style diet rich in fiber and healthy fats is a great foundation. Dr. Zalzel notes that when he experimented with going vegetarian for a year, his own cholesterol dropped by 20%.
When Lifestyle Changes Aren’t Enough: Calculating Your Personal Risk
So you’re doing everything right, but your cholesterol is still high. Is it time for medication? That depends on your other risk factors, like age, blood pressure, and family history.
Doctors use tools like the Framingham Risk Calculator to estimate your 10-year chances of a heart attack or stroke. You’re generally considered:
- Low risk if your score is less than 10%
- Intermediate risk if your score is 10-20%
- High risk if your score is over 20%
While the algorithms can be complex, the gist is simple: The higher your risk, the more you stand to benefit from cholesterol medication.
Statins: The Most Prescribed (and Controversial) Cholesterol Drugs
Statins are the heavy hitters of the cholesterol-lowering world, and they have the studies to back them up. Trials involving hundreds of thousands of people suggest statins can lower heart attack and stroke risk by 25-30%.
But they’re also lightning rods for controversy. “There has never been a hate on for a particular medication class than statins probably in all of medicine,” says Dr. Heffernan.
Part of the mistrust stems from a potent statin called cerivastatin that was withdrawn in 2001 after being linked to severe muscle damage. But the statins used today – like atorvastatin, simvastatin, and rosuvastatin – have much better safety profiles.
Beyond Statins: The Next Generation of Cholesterol Meds
If statins don’t agree with you, take heart: There are other options on the market, with more on the horizon.
Ezetimibe (Zetia) is a pill that blocks cholesterol absorption in your intestines. The injectable drugs alirocumab (Praluent) and evolocumab (Repatha) help your liver vacuum up more LDL from your blood. And bempedoic acid (Nexletol) is an innovative new medication that lowers cholesterol synthesis without the muscle pain some people get from statins.
With expanded options and personalized prescribing, the future of cholesterol management looks brighter than ever.
The Bottom Line: Knowledge Is Power
When it comes to heart health, what you don’t know can hurt you. By understanding your cholesterol numbers, personal risk factors, and medication options, you can have an informed discussion with your doctor and make empowered choices.
No one loves the idea of lifelong medication. But for many people, the benefits far outweigh the downsides. “It’s all about risk,” Dr. Heffernan emphasizes.
You may be the one who can beat the odds with lifestyle tweaks alone. You may be the one who needs medication to avoid becoming a statistic. But you’ll never know unless you ask the question and weigh your options.
Managing cholesterol is a marathon, not a sprint. But with science, support, and smart decisions, you can give yourself the best shot at a long and healthy life. And that’s a cause for celebration.
Frequently Asked Questions
Can I lower my cholesterol with natural remedies?
Certain foods and supplements like soluble fiber, plant sterols, and omega-3s may help nudge your numbers in the right direction. But “natural” doesn’t necessarily mean effective (or harmless). Always talk to your doctor before starting any new regimen, and don’t stop a prescribed medication without medical guidance.
How often should I have my cholesterol checked?
Most experts recommend a cholesterol check every 4 to 6 years, starting at age 20. You may need more frequent tests if you have a family history of high cholesterol, heart disease, or stroke. Your doctor can suggest a personalized screening schedule.
Can high cholesterol be cured?
In most cases, high cholesterol is a lifelong issue that needs to be managed with diet, exercise, and/or medication. While you may be able to lower your numbers into a healthy range, genetic factors mean they’ll likely creep back up if you stop treatment. Commit to small, sustainable lifestyle upgrades for the long haul.