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What does cholesterol do? What’s the difference between good and bad cholesterol? And importantly, what can you do to try to lower your cholesterol? Cardiologist Leslie Cho, MD, tells you what you need to know about cholesterol, including what it is, why it matters so much and how you can naturally lower yours through diet, exercise, stress management and more.

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How to Lower Your Cholesterol with Dr. Leslie Cho

Podcast Transcript

Speaker 1:

There's so much health advice out there; lots of different voices and opinions. But who can you trust? Trust the experts, the world's brightest medical minds. Our very own Cleveland Clinic experts. We ask them tough intimate health questions, so you get the answers you need. This is the Health Essentials Podcast, brought to you by Cleveland Clinic and Cleveland Clinic Children's. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.

Kate Kaput:

Hi, and thank you for joining us for this episode of the Health Essentials Podcast. My name is Kate Kaput, and I'll be your host. Today we're talking to cardiologist, Leslie Cho, about natural ways to lower your cholesterol. Dr. Cho, thank you so much for being here with us today.

Leslie Cho:

Oh, thank you so much for having me.

Kate Kaput:

I'd like to start by asking you to tell us a little bit about your work here at Cleveland Clinic. What kind of work do you do and what sort of patients do you typically see?

Leslie Cho:

So I am a interventional cardiologist, that means I put stents in, but I have a true passion for prevention. So currently I am the section head for Preventive Cardiology at Cleveland Clinic, also the director of the Women's Cardiovascular Center. We see about 11,000 patients a year in preventive cardiology.

Kate Kaput:

Wow. OK. So to give us a little bit of a baseline for today's conversation, can you give us cholesterol education 101? What is cholesterol exactly, and why is it important to our bodies?

Leslie Cho:

So cholesterol is this waxy-like substance, and we all need cholesterol because cholesterol makes cell membrane. And cholesterol comes from animals. Mostly our body produces cholesterol, but you can also find cholesterol in plants. Now, cholesterol, unfortunately, as we get older, our cholesterol level goes up, and in some of us, actually many, many of us, the cholesterol level becomes way too high. And that cholesterol, unfortunately, if it's not eliminated in our body, can lay down in our blood vessels causing heart attack and stroke and dementia.

Kate Kaput:

OK, great. So that was one of my next questions. Can you go a little bit deeper into what risks, what health risks are associated with having high cholesterol?

Leslie Cho:

Yes. So if you have high cholesterol, some of us have genetically very high cholesterol, it can cause heart attack and strok. And the way it does that is that it lays down in our blood vessel and you build up blockages. Now, people can also have vascular dementia. So having high cholesterol can also cause dementia.

Kate Kaput:

Now, we hear about good and bad cholesterol. Can you explain a little bit to us about the different types of cholesterol and what those mean?

Leslie Cho:

Yes. So when you get a cholesterol level, you get it at your doctor's office, you get four numbers, actually it's four to five numbers, but the important ones are total cholesterol. And then you get something called HDL, HDL, H for happy, that's good cholesterol, it goes around your body and it's like a vacuum cleaner. It sucks out cholesterol from the blood vessel. Now, some people have something called dysfunctional HDL. So you can have very, very high levels of the good cholesterol, the HDL, happy cholesterol, but it goes around your body and does nothing.

Now, the bad cholesterol is called LDL, L for lousy. And LDL, the higher level it is, the worse off you are. So when we look at epidemiological studies, when we look at genetic studies, people with very high levels of LDL, they go on to have heart attack and stroke, and there are genetic cholesterol problems, for example, there are families that have inherited disorder called familial hypercholesterolemia, where children, as young as 18 can have their first heart attack, and you get their cholesterol level drawn and their LDL, even when they're very, very young, are through the roof.

              So when we're born, our bad cholesterol is somewhere around 10. And as we get older, it continues to go up, and as you hit menopause, it goes up. As you get older, it goes up. Now, there's another level that you get, it's called triglyceride, and triglyceride is another fat like substance. It's a little bit different than the LDL, but nevertheless, having high triglyceride also increases your risk. The way you lower triglyceride, we'll talk about it on another podcast, but is a little bit different than LDL.

Kate Kaput:

OK. So I think the that's really helpful, the happy cholesterol and the lousy cholesterol, and then triglycerides kind of on their own. You already mentioned, you started to mention genetics, which is one of my next questions. We're going to talk in a little bit about some of the lifestyle factors that affect cholesterol levels. But what else can you tell us about how much is related to genetics and how common it is to have genetically high cholesterol, etc?

Leslie Cho:

So most people do not have genetically high cholesterol. Most people get it the good old fashioned way, which is diet, which is lack of exercise, and also the whole beautiful process of aging. There are those of us that are genetically inclined to have high cholesterol. The worst case scenario is something called familial hypercholesterolemia, and people who have that have heart attacks at the age of 18 and they have LDL, the bad cholesterol, the lousy cholesterol, that are greater than 200 at a very, very young age. And those are people that we put on medicines aggressively because they tend to have very bad outcome. Now, some people can have something called the heterozygous FH. That means you have a milder version of that genetic cholesterol defect, and those people, their LDL is somewhere hanging out in the high one hundreds. So they can have somewhere around one seventies and above. And those people come to us usually in their 30s and 40s, because they've had a cholesterol screening from their job or when they were trying to get life insurance and they were astounded to find their cholesterol level so high.

Kate Kaput:

Are there any other early warning signs of having inherited high cholesterol? Can you do anything to manage high cholesterol if it's part of your family health history?

Leslie Cho:

So I'll start with the easy question, and the easy question is, is that there are absolutely wonderful ways to manage high cholesterol. And the wonderful news in 2022 is that heart disease is 90% preventable. And even if you have significant family history, you can prevent heart disease. I mean, that's an unbelievably happy news and let's just start right there because that's amazing.

              The ways to know if your cholesterol level is really, really high is through family history, the American Pediatric Academy. So the Pediatric Academy recommend that all children get their first cholesterol level at age seven. And that is not to start these kids on medicine, but just to get a baseline, to screen out people who are at higher risk, so they can be monitored more closely, they can have more aggressive diet and risk factor modification. Let's say you are beyond the age of seven, the American Heart Association and the American College of Cardiology recommend that your cholesterol level be screened at age 20. OK? So I know there are many people out there who are young and they feel invincible, like they're going to live forever, never have any problems, but truly you should get your baseline cholesterol level at age 20. And every five years thereafter, if you don't have any risk factors, but if you do, then yearly thereafter.

Kate Kaput:

And how exactly do you get cholesterol screening? What does that entail?

Leslie Cho:

Oh, it's a routine blood test. It used to be that we used to make you fast for 12 hours, but now we actually do, at least at the clinic, we do a test where you can have non fasting cholesterol level, and it's a very good way to figure out what your cholesterol level is. A lot of people have job screening health fair, where they go and get their blood tests. It's a simple blood test. Now, you had asked a question about like, well, you've never gotten a blood test, how do you know if your cholesterol level is really high?

               There are some people in whom it's so high. Cholesterol has to go somewhere. If it doesn't come out of your body, it goes in your arteries, and if it doesn't go in your arteries, it doesn't go in your liver, it manifests itself through your skin. So when you have very, very high levels of cholesterol, you can have cholesterol deposition in your hands, in your joints. So the joints around your hand, on your elbow, or on your knee, you can also have cholesterol deposition around your eyes. If you look at the Mona Lisa painting very carefully, the Mona Lisa painting by Leonardo da Vinci, very famous, Mona Lisa actually has cholesterol deposition around her eyes and around her thumb joints.

Kate Kaput:

Learn something new every day. And so it sounds like getting your cholesterol tested is nice and easy blood test, get it done early so that you know. So let's talk a little bit about lifestyle factors and how they impact your cholesterol. Starting with the food we eat, how does diet play a role in cholesterol levels?

Leslie Cho:

So diet is a very, very important risk factor for developing high cholesterol. Now, if you think about what we eat, what we eat are nothing but fat, protein, and carbs. If you eat a lot of things that come from animals, that all has cholesterol in it. Now, for sure plants contain something called phytosterols or stanols, which are also cholesterol, but those are good types of cholesterol. Whereas the animals tends to be the worst type of cholesterol. So if you eat a lot of cholesterol animal foods, so I know during the keto diet craze, people were eating nothing but animal stuff. Some people had extremely elevated LDL.

              Now, there are things like coconut oil, which can really increase your LDL too, we can talk about that in a little bit, but diet really makes a humongous impact. If you eat a lot of sugary food or carbs, it increases triglycerides, not necessarily your LDL, but your bad cholesterol. The LDL is usually increased by anything that comes from an animal. So that obviously means cheese, butter, dairy products, and then of course, meat. Eggs have a lot of cholesterol, you have to eat some eggs, but we'll talk about some of that as we get through this podcast, but it really is from an animal.

              Now, sedentary lifestyle really makes that worse, because if you're sedentary, you can lower your cholesterol by exercising, you can lower your cholesterol by really limiting the type of food that you eat. There are those of us who are called hyper absorbers of cholesterol from our stomach and our intestine. For those people, that's about 15% of us, if you go to a vegan diet or even a vegetarian diet, but really an extreme vegan diet, you can lower your cholesterol dramatically. But the rest of us, 85% are moderate absorbers of cholesterol. So even if we were to make extreme dietary changes, sometimes we don't get as dramatic of an impact.

Kate Kaput:

Got it. So talk to us a little bit more about those types of fats. Which are the kinds of fats that we should be consuming and which should we limit? I know we hear a lot about trans fats, mono saturated fats, and your average person kind of maybe doesn't know the difference. What can you tell us about what know about what fat is what and what they do to us?

Leslie Cho:

Yes. So the best type of fat is the mono and the poly unsaturated fat. Those are the best type of fat. And those are things like olive oil. Mono is better than poly, but it's OK. They're just as great for your body, but those are the best type of fat. So those come to us from olive oil, those comes to us from nuts, they come to us from fish, omega-3 fatty acids. So those are the really good type of fat.

Trans fat, which are the bad fats, which you should really never get any trans fat, is solid at room temperature. It's the easiest way to tell. The kind of fat that's solid at room temperature are the kind of fat you don't want to have. And they really have a negative impact. Not only do they have worsening cholesterol, they really increase your markers of inflammation, which are really bad things, when your body is inflamed, your blood vessels become inflamed and you tend to have more heart attacks. So the trans fat, the solid fat at room temperature, you should really avoid.

              Now, how can you tell when you're at the grocery market or when you're at the local whatever store, whether something's made out of trans fat or not? In general, baked goods that are left there for a long time, think of all the baked goods that are on the shelf that are good for like a year, that's for sure trans fat because there's no way you can have something like that. So we want you to avoid those things. Diet is one of those things where everybody feels like, oh my God, I can't stand the word diet, and then we don't use the word diet either. It's a lifestyle. You have to embrace healthy eating habits, because you're not just eating for that day, you're eating for longevity, but high quality of life. And really we want you to think about it in terms of trying to make healthy decisions that will make you feel better. Forget just making you feel full, but make you feel better.

Kate Kaput:

I like that a lot, that you're not just eating for today. You're eating for all the days that come after. That's a good way to think about it. So you've started to mention some of these foods along the way as we've been talking, but what are some of the best foods for lowering your cholesterol levels, or for keeping your cholesterol levels low?

Leslie Cho:

OK. So these are easy things. Americans are inundated with random information about diet, like one day peanut butter's good, next day peanut butter's bad, eggs are good, eggs are bad. My God, what do you eat? Nothing. Easiest thing to lowering your cholesterol is to switch to a plant-based diet. And plant-based diet really means eating diet that's mostly plants, and then really trying to have a variety in your diet. So obviously we want you to have protein because it's so important for muscle mass for making you feel full, it's really good for your brain. So the best type of protein for lowering your cholesterol, but also for lowering your cancer risk, also for brain health, is plant-based cholesterol, then comes fish. And so the best type of fish are the oilier and smellier they are, so salmon, mackerel, herring, sardine, tuna, then comes chicken and turkey. And then at the very, very bottom, comes beef and pork and shrimp and lobster. Shrimp and lobster are not fish. They're crustaceans. And so they're not fish. I know people think they're fish, but they're not. Remember junior high school.

              And then the other type of food like eggs, of course you can have eggs, but now probably you should be mindful about how much egg yolk you have. You can have as much egg white as you need. Now, everyone has heard the commercial from Cheerios and oatmeal, that oatmeal and Cheerios lower cholesterol. The way they do that is by binding your cholesterol and eliminating it from your body. The easier way to do that is to increase soluble fibers in your diet. We usually recommend 30 grams of soluble fibers a day. Some people can get it through just eating. Sometimes people don't want to eat that much fiber, so then we recommend that they get on Metamucil, which is psyllium, at two grams a day, to bind cholesterol and eliminate it from your body.

Kate Kaput:

So when you say that the best protein is plant-based protein, are there specific kinds of foods that you have in mind, plant-based foods, that are high in protein, that if people are trying to cut out red meat, as you said, that they might want to bulk up on instead?

Leslie Cho:

Yes. So beans and legumes are very good. They're very high in protein. Surprising things have high in protein like spinach. Who knew spinach was high in protein? Right? I mean the beauty of Google and the internet is you can find lots of plant. So I just said to you beans and spinach and legumes have high in protein. You hate those foods. OK, fine. There are hundreds of others you can find that are plant-based, that you can get high protein from. And so it's really important to find a diet that you can do, that you can make it into your natural daily routine without it being onerous.

Kate Kaput:

And I would imagine that you can start small to too, making some of these smaller swaps. Instead of cheese on your salad, maybe you put avocado on your salad. Instead of a creamy dressing, you use an olive oil and vinegar. Little tricks along the way to help it normalize for you. Is that right?

Leslie Cho:

Absolutely. I mean, we've heard a lot about micro habits in 2022. And micro habits really actually I think have some benefit, making tiny little steps. Maybe you really, really loved eating something like hamburgers, maybe at least once a week, you can go to a plant-based burger instead of a traditional meat burger, or trying at least to incorporate maybe chicken instead of beef in one meal. We think about meals, we think about convenience, we think about all these things, but one of the things I always want to tell patients is that food is a source of medicine, and we have to think about food mindfully, instead of just thinking about convenience factor. Aristotle, I think, or maybe Hippocrates, I don't know, one of those guys, once said that let your food be your medicine and medicine be your food, and I think that's really important to remember. That what we consume, that what we put into our body is really important. And being mindful of that and being cognizant of that is a very important step in having good, healthy heart and brain.

Kate Kaput:

That makes a lot of sense. Thank you. So let's talk about some other healthy habits, starting with smoking. We all know that quitting smoking does all kinds of things for your body. Can you talk to us specifically about how avoiding tobacco or quitting tobacco is good for your cholesterol levels?

Leslie Cho:

Oh, I don't really ... I mean, we want you to quit smoking, forget cholesterol. These are additive factors, additive risk factors. So smoking is so bad for your heart and smoking really truly is one of the worst things we could do, not just for your heart, but for your brain and your lungs and all sorts of things. And I know that one of the sad statistics is that younger people are taking up smoking and thinking vaping is safe and it really is not. It's really bad for your lungs. But these risk factors are additive. So you smoke and you have high cholesterol, you have now doubled your risk. You smoke, you have high blood pressure, and you have cholesterol, it's additive. It's really additive. So it's really important for your children, for yourself, for your longevity, but for your quality of life that you don't smoke.

Kate Kaput:

So cholesterol is just one of the many things to add to the list of reasons to quit smoking. Let's talk a little bit about alcohol. Does drinking alcohol affect your cholesterol?

Leslie Cho:

It does. It does. This is a really important factor. There is something called triglyceride, which we kind of talked about earlier on in the podcast. People who drink a lot of alcohol, because alcohol is made from sugar, they have very high triglycerides. And really high triglyceride increases your risk for diabetes, for pancreatitis, and having high triglycerides in women is especially problematic because it increases your risk for stroke. And so it's really important to try to control your triglyceride.

              Now, alcohol, we used to say, oh, if you drink alcohol, you can lower the risk. That is kind of questionable, because that statement has a lot of ifs next to it, and that is, is you don't take up alcohol just to lower your risk because it's empty calories, you drink in moderation, that means six ounces of red wine for women, eight ounces for men, or one to two ounce of hard liquor, or 12 ounces of beer, and you really try not to exceed that a day. Alcohol can also increase our good cholesterol, our HDL, but there's some data that says that the good cholesterol that's increased by alcohol is dysfunctional. So you may have a lot of it, but it really does nothing.

Kate Kaput:

All right. So don't drink alcohol to try to better your cholesterol levels, at least. Let's move into talking about exercise. Can exercise impact your cholesterol level and how, and how much exercise is recommended for lowering your cholesterol or keeping it low?

Leslie Cho:

Yes, that's a great question. So exercise can definitely impact your cholesterol level, especially your HDL and your triglyceride. It has a dramatic impact on your good cholesterol and your triglyceride. If you lose weight, your HDL will go up and your LDL will come down. Now, probably the total cholesterol, if you lose like the 5-10 pounds can be lower by about 5%-10%. Now, I want you to exercise for cholesterol, but more than cholesterol. Exercising is good for your mental health. Exercising is amazing for your blood pressure, which is an important, important risk factor. Exercising has a dramatic impact on whether you get diabetes or not, another amazing benefit of exercise. Most people, most societies, so American Heart Association, the American College of Cardiology recommend that you get about 30 minutes most days of the week. Now, that number seems like ridiculously high number for those of us that don't exercise.

              But what I want everyone to remember is that you don't start at 30 minutes. You start maybe at five minutes, and you do what you can. And then maybe in two weeks, you go to 10 minutes. Maybe exercising means you get off one floor before your destination off the elevator and walk up that extra flight of stairs. Maybe it means parking further away and you walk rather than try to fight for the nearest parking spot at work. These little things make a very big difference. But exercise, we always think of exercises yet another chore in our very, very busy day, but it really has an amazing, amazing benefit. And if we can bottle exercise and sell it, it would be the best, best, the most effective pill that we've ever made.

Kate Kaput:

So again, with those micro habits, it sounds like a little bit can go a long way and kind of help you build up better all-around habits. You mentioned this a little bit, but eating well and exercising frequently can all result in weight loss. Talk to us a little bit more about how your weight impacts your cholesterol.

Leslie Cho:

There's a very good data that says that if you lose around ... so most of us, most of us are carrying extra weight. And if you lose around five to 10 pounds, you can have a dramatic impact on your blood pressure, your risk of diabetes, and your cholesterol level. It really does make a dramatic impact. Now, that diet and exercise, it's so easy to say and so incredibly hard to do. And if we think about diet, we go on these restrictive diet and once we stop the diet, we gain weight and it's like a yoyo, actually yo-yoing is really bad for your body, because it really does mess up your metabolism. It really has a adverse effect on your metabolism. But if you can try to think of it as making a, not a diet, but a lifestyle modification changes, where you start eating more healthy, exercising just a little bit more, I think that's a better way to think about "diet.” We usually recommend losing one pound a week.

              Now, I know that sounds like, oh, one pound a week, that's like ridiculously low, but that's what we recommend because one pound a week weight loss means you have made some small progress in your weekly eating habits. If you make dramatic weight changes, like remember for a while it was like this soup diet where people were losing like seven to 10 pounds a week. All of those people, I guarantee gain their weight back, because that's not sustainable. But if you lose a pound a week and let's say that takes you 10 weeks to lose 10 pounds or maybe 20 weeks to lose 20 pounds, that's a sustainable weight loss that you can maintain. There's very good data that you use diet, eating to lose weight, but you use exercise to maintain weight loss. That's very good scientific data behind that. Unfortunately, a lot of times when you exercise, you get more hungry, so some people notice that they're not losing as fast and they get discouraged. But really truly one pound a week of weight loss is what we recommend and what's been shown to predict people who will have sustained weight loss.

Kate Kaput:

So sustainability is the key. Again, small habits to make big changes. Let's talk about something else that can be a little bit difficult for people to keep under control and that's stress. What role does stress and maybe even anger or kind of other stressful emotions on the body, what role do those play in your cholesterol level?

Leslie Cho:

Yes, so stress is a really, really bad player because stress not only produces this hormone in our body that makes our blood pressure high, our heart rate high, and then cause heart attack and stroke, but stress makes us eat badly, do bad things, right? Stress makes me eat more food, stress makes me sleep less, stress maybe makes us drink more alcohol. Maybe some of us can't quit smoking because we're stressed out. Stress is a really potent risk factor. We used to think stress had very little role, but now we know stress has an incredibly important role in cardiac health. In fact, if you ... at like extreme levels of stress, it can cause something called broken heart syndrome or stress-induced cardiomyopathy.

              There's a very interesting fact, Dick Chaney had his first heart attack during his first congressional run. He was probably a little bit stressed out. He probably had some family history. It's just a perfect storm. And stress, especially during COVID-19 and during the last two years, has really been weighing all of us down in terms of our ... we've become more sedentary, we've been eating more bad food, remember the whole baking craze for a while. That's probably as a reaction to stress. But trying to get stress under control, there are some really good ways. Probably the best way is exercise, mindfulness. There are some breathing apps that are out there that are completely free that can really lower the stress immune sort of the stressful response that we have.

Kate Kaput:

Now, in addition to food, are there any supplements or anything like that that you can take that can help lower your cholesterol?

Leslie Cho:

Yes, there are, and that's actually good news. I know if you go to the local vitamin store, there's like a whole section on how to lower your cholesterol using vitamins. But there are a couple of things that really work and the rest probably doesn't work. So I'm going to go through them, and there'll be hopefully links on our Cleveland Clinic website that you can follow that you'll be able to read about. But there are a couple of absolutely natural ways to lower cholesterol. One is what we talked about, which is psyllium, which you probably know as Metamucil™. We want you to take two grams a day to lower your cholesterol, because that finds cholesterol and eliminates it from the body. The other one you've probably heard a lot about is ground flax seed. Ground flax seed does lower your cholesterol, two tablespoons with your yogurt, with your cereal, that really makes a big impact. Once you open the seed, you need to put it in the refrigerator because it goes bad right away.

              The other little tidbit, it's an important tidbit, is there's ground flax seed oil. It's not as good. It's not as good as actual seed. So get the seed and not the oil. It's cheaper too, the seed. The red rice yeast that you'll find in your local vitamin store does lower cholesterol, but it is not, it is not "completely natural.” It's the same compound as a statin called lovastatin. So it's really important before you take that, even though you can find it over the counter, that you talk to your doctor. There are Niacin, you probably have seen Niacin. It's a vitamin. It does lower your cholesterol. But you really should talk to your doctor about that because Niacin ... there have been some association with increase in bleeding in your brain and there's also some people who are on certain medicines who should not be on Niacin. So really talk to your doctor, especially if you're diabetic.

              The other interesting thing that some of you have probably heard about is something called plant sterols or plant stanols, which are phytosterols. These are plant cholesterol. You take them, sometimes it comes in the form of vitamin supplements, sometimes it comes in your orange juice or margarine or in your butter. It's included. It can compete with animal cholesterol and lower your cholesterol level. If you are going to get a vitamin supplement that's phytosterol, you should get at least 0.9 grams, and there are two brands that provide 0.9 grams and you can find those on our Cleveland Clinic website, and you can look for them.

              And then lastly, you'll hear a lot about garlic and grape seed and all sorts of things. Save your money, save your money for something good, like sneakers so you can go exercise, but they really don't lower your cholesterol. And then lastly, having a lot of fiber in your diet. So at least 30 grams of soluble fiber can really lower your cholesterol. And then for certain patient populations, so if you have a history of breast cancer in your family, or you're a breast cancer survivor, we don't recommend a lot of soy, but if you don't, then soy protein, 25 grams of soy protein also is excellent.

Kate Kaput:

Great. That's a long list. It seems like there are a lot of options there. If you're trying, you think you're doing the best you can, you've taken everything into consideration, you're really trying to lower your cholesterol and just can't seem to move the needle on your own, when is it time to talk to your doctor and what are some of the ways that they can help?

Leslie Cho:

Yes. I mean, in the era of Google, we all think we're doctors, but let your doctor be your doctor. There are some really important risk factor assessment out there. And so there are these tools that really help us guide who should be on medicine and who should not be on medicine. Let's say your cholesterol level is super high, like your bad cholesterol is 190, it's really important to talk to your doctor as you're doing your natural ways to lower your cholesterol, because we really think that it's a partnership. It's a shared decision making. But if you have a family history of early heart disease, it's really important to talk to your doctor. Even if you're going to start natural ways to lower your cholesterol, it's really important to talk to your doctor because it's a conjunction, it's a partnership. If you notice that you have tried to do diet for the last six months and you have not been able to move the needle very much, then you should really talk to your physician. Diets, if you really do a good job, it takes about six months for you to see some effect.

              It also depends on where you are on the risk of developing heart attack and stroke, and how long we let you go without any medication. Being on medicine doesn't mean you're going to be on medicines forever, for some people. Now, there are people who've had heart attack and stroke and whom we will be on lifelong therapy, because we don't want them to have another heart attack or stroke, or need another bypass surgery. But for many people, you don't maybe need to be on medicines forever. Now, the other important thing to remember, and this is really important for us to remember, is I know people don't want to go on medicine, but that's not the goal. The goal is to live a long time with high quality of life without heart attack or stroke or dementia. If you get there with medicine, OK. If you get there without medicine, OK. But the goal, the goal is living a long time with high quality of life.

Kate Kaput:

Perfect. Dr. Cho, as we start to wrap up today, is there anything that we haven't discussed that you think is important to this topic for our listeners to know?

Leslie Cho:

The most important thing I want all of our listeners to know is, here's great news in 2022, heart disease is preventable. You're in control. You can do it. Even if you can't do it with diet and exercise, there are some amazing medications out there. Aren't we so lucky to live in an era where we can have something that can treat our disease so that we can live a long time, don't have heart attack or stroke or dementia? And the other really important thing is, is what's good for the heart is really good for the brain. And so by lowering our cholesterol, by controlling our blood pressure, by not getting diabetes, and not smoking you, you can have a dramatic impact on your heart health, but also on your brain health.

Kate Kaput:

What a great and hopeful note to end on. Thank you so much, Dr. Cho, for being here today and for speaking with us on this important topic.

Leslie Cho:

Thank you, Kate.

Kate Kaput:

To learn more about heart health at Cleveland Clinic, please visit clevelandclinic.org/heart, or to make an appointment, call 800.659.7822. Thank you so much for joining us today.

Speaker 1:

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