Genetics, statins, exercise are the big take aways. I had a heart attack 6 months ago. My dad had 4 , brother had 2, and little brother has stents. I tried many alternatives - nothing changed the cholesterol needle until I went on statins. I do fasting every few months to repair my liver. my cariologist said there is some heart health benefit , but he doesn't want to go through the ordeal himself - 2 other MDs I know do it. alcohol is a no-no. It raises my blood pressure, makes me tired, and screws up my liver and metabolism. Exercise along with red beet power help make me feel younger and fresher. I mix red beet power with metamucil to improve the nasty flavor and further reduce cholesterol. latest problem is my hips, knees, and ankles have arthritis , so it is challenging to stay fit. I take condroitin - glucosamine for the achey joints. Another issue is sleepiness - I need about 10 hours of sleep with all the meds I take - statins, amlodapine, and plavix.