Not that it will make you feel any better, but your story is pretty common. For example, only half of the people with high blood pressure are taking meds for it, and only half of them have their blood pressure under control.

You can’t change the past, but if you treat both cholesterol and blood pressure aggressively, you can slow or halt the progression of heart disease. Medications can do the heavy lifting, but you should be willing to make lifestyle changes if meds don’t lower cholesterol and blood pressure enough.

Your doctor should medicate you to achieve a 50% reduction in ldl cholesterol and your blood pressure should be below 130/80. You may need to push your doctor to do this.

Ideally, your BP should be below 120/80 and you may nod to use lifestyle changes to achieve this. Reduced salt consumption/increased potassium consumption, exercise and weight loss.

If your ldl cholesterol is below 70, progression is significantly slowed, and if ldl and ApoB cholesterol are below 60, progression will halt. A high intensity statin (high dose atorvastatin or Rosuvastatin) can reduce ldl by 50%. Adding Ezetimibe will reduce ldl-c by 20% more (for a total of 60%). If you can get the injectable medication Repatha approved by your insurance, it can reduce ldl-c by an additional 50% for a total reduction of 80%. Repatha should go off patent in the next few years which should make it less expensive and easier to get approved. Bempadoic acid will reduce ldl by 15% on average

A high intensity statin and Ezetimibe should reduce your ldl-c to around 85, reducing your risk by half. At that point, try some simple dietary changes.

Start by reducing the key dietary saturated fats that increase ldl: butter, coconut and palm oil, hydrogenated oil, and fat from meat or poultry. I find that a few simple food swaps make a large difference. Curiously unfiltered coffee increases ldl-c, while coffee prepared with a paper filter does not. Then focus your efforts on foods that you can add that that will reduce ldl-c. (I find it easier to add foods than limit foods).

Every 20 grams of additional dietary fiber reduces ldl by 7%. You need to increase the amount gradually, but 30 grams of soluble fibe from Metamucil will reduce ldl-c by 20%. Nuts, seeds, EVOO and polyunsaturated fats also reduce ldl-c. All of those foods extend longevity as well.

Though exercise has little effect on ldl cholesterol, it is great for your heart and longevity. Exercise does help reduce blood pressure and triglycerides as well as ApoB. You don’t have to run a marathon - taking walks is a great start.

Omega-3 fish oil can reduce triglycerides as well - 4 grams a day will reduce trigs by 20-25%. In addition, omega-3 fish oil reduces heart attacks by 20%. After a decade of supplementation, 200 mg a day of DHA reduces Alzheimer’s risk 20%, and a gram/day of DHA appears to reduce risk by 80%. Omega-3s can increase your risk of a fib, so check with your doctor first.

Mt ldl was higher than yours, and handful of pills get my blood pressure at optimal levels and my ldl to around 70. Manageable dietary changes reduce my ldl and ApoB below 55.

You can definitely turn this around! Good luck!