High cholesterol is one of the heart disease risk factors that you have control over. Here’s an overview of how to manage high cholesterol through a combination of diet, lifestyle changes, and medication.

How to Manage High Cholesterol: Diet, Medications, and More

Cholesterol isn’t inherently bad. Your body needs the waxy, fat-like substance to produce cell membranes, hormones, and nutrients like vitamin D. But too much of it — especially low-density lipoproteins (LDL) cholesterol, which accumulates in the walls of your blood vessels and is also referred to as “bad” cholesterol — can increase your risk for heart disease and stroke.

The good news? High cholesterol is one of the heart disease risk factors that you have control over. There are many changes you can make to bring down your cholesterol levels, which in turn will strengthen your overall cardiovascular health. Here’s an overview of how to manage high cholesterol through a combination of diet, lifestyle changes, and medication.

How to lower cholesterol levels with diet

There are two sources of cholesterol: your liver and the foods you eat. This means that you can begin to lower your cholesterol simply by paying attention to your diet and limiting high-cholesterol foods.

There are several categories of high-cholesterol foods to pay attention to. Saturated fats, which are typically solid at room temperature, increase levels of LDL cholesterol in your blood. You don’t have to avoid saturated fats altogether, however you should try to decrease your consumption of them. The American Heart Association suggests aiming for a diet in which 5-6% of the total calories consumed come from saturated fat. Common sources of saturated fats include red meat and full-fat dairy products.

Trans fats, also known as partially hydrogenated oils, are mainly formed through an industrial process which causes oil to become solid at room temperature. These fats are considered the least healthy to eat and should be avoided altogether as much as possible. While the Food and Drug Administration has banned food manufacturers from adding trans fats to foods, it’s still a good idea to check the label of the following foods for partially hydrogenated oils (how trans fats appear on nutrition labels): 

Cookies, cakes, and other baked goods, including frozen products

On the other hand, unsaturated fats — found in plant-based oils such as olive oil and canola oil as well as tree nuts like almonds, walnuts, and pecans — can lower high cholesterol levels. Omega-3 fatty acids — found in fish like salmon, mackerel, herring, and tuna — and soluble fiber — found in beans, peas, lentils, oats, and whole grains — will round out a low-cholesterol diet.

Other lifestyle changes can significantly lower your LDL cholesterol levels naturally, including exercising regularly, maintaining a healthy weight, avoiding cigarette smoke, and limiting your alcohol consumption.

Moderate physical activity can help lower LDL cholesterol and increase high-density lipoprotein (HDL) cholesterol, or “good” cholesterol. Aim for about 30 minutes of moderate to intense exercise per day. Everyone’s fitness needs are different, and it’s okay to start slower and work your way up to more vigorous activity.

Being overweight or obese increases your levels of LDL cholesterol, since excess body fat impacts your body’s ability to clear LDL cholesterol from your bloodstream.

Doctors may calculate your body mass index (BMI) to determine if your weight is in a healthy range. Consult your doctor about what a healthy weight is for you, and work together on a diet and fitness plan to help you reach and maintain that weight.

Smoking when you have unhealthy cholesterol levels increases your risk of heart disease even further. In addition, both smoking and vaping lower HDL cholesterol. Quitting can both lower your LDL cholesterol (bad) and increase your HDL cholesterol (good) levels.

If you currently smoke, ask your doctor for smoking cessation resources such as nicotine replacement therapy (NRT), which reduces withdrawal symptoms. If you are a nonsmoker, try to avoid exposure to secondhand smoke.

Too much alcohol can increase your cholesterol levels, so it’s important to limit your intake as you work on managing your cholesterol. The CDC recommends no more than two drinks per day for men and no more than one for women.

How to manage high cholesterol with medication

For some people, diet and exercise may be enough to manage cholesterol levels. In other cases, medication may be necessary to lower LDL cholesterol levels, increase HDL cholesterol levels, or both. There are several different classes of cholesterol medications. Your doctor can advise you on the best option for your needs.

Statins, also known as HMG CoA reductase inhibitors, act on the liver to prevent cholesterol from forming and limit the overall amount of cholesterol circulating in your bloodstream. They are most effective at lowering LDL cholesterol but can also help increase HDL cholesterol and lower triglycerides, or blood fats.

In most cases, side effects are mild and often disappear as your body adjusts to the medications. Your doctor may order tests on liver function, but liver abnormalities are rare. Statins are not safe to take if you are pregnant or you have chronic liver disease.

Ezetimibe (Zetia®) is a cholesterol absorption inhibitor and the most commonly used non-statin cholesterol medication. Potential side effects include:

This medication is not safe to take during pregnancy or while breastfeeding.

PCSK9 inhibitors bind to a protein found in liver cells to lower LDL cholesterol. They are administered as injections every 2-4 weeks. Commonly prescribed medications in this class include:

The primary side effect is itching, swelling, pain, or bruising at the injection site.

ACL inhibitors act on the liver to block cholesterol production. They are often taken in combination with statins to help further lower LDL in people with heart disease and people with familial heterozygous hypercholesterolemia, a genetic condition that causes high LDL cholesterol.

Commonly prescribed ACL inhibitors include:

Bempedoic acid and ezetimibe (Nexlizet®)

There are several additional medication classes which are not as commonly prescribed but do have a proven mild LDL-lowering action, including fibrates and niacin.

Fibrates are primarily used to lower blood triglyceride levels, however they may also be used to raise HDL and lower LDL cholesterol. 

Fenofibrate (Antara®, Lofibra®, Tricor®, and Triglide™)

Potential side effects include nausea, stomach pain, and muscle pain.

Niacin is a B vitamin that reduces the liver’s production of blood fats. It is very effective at lowering triglycerides and is sometimes prescribed to lower LDL cholesterol.

Niacin comes in prescription form and as a dietary supplement. The latter is not a replacement for a prescription, and it’s important to only take niacin if your doctor has prescribed it.

Liver function should be closely monitored while taking niacin. If you have diabetes, it’s important to discuss the potential risks and benefits of niacin with your doctor, as it can raise blood sugar levels.

There often are not any visible signs or symptoms of high cholesterol, so the only way to determine your cholesterol levels is through a simple blood test called a lipid profile.

Most adults who are in good health have their cholesterol checked every four to six years. If you have heart disease, diabetes, or a family history of high cholesterol, you will need more frequent screening. Consult with your doctor about recommended screening frequency.

Exceptional pharmacy care to strengthen your health

At Alto, we’re committed to making it as simple as possible to stay on top of your cholesterol-lowering medications. We offer same-day delivery and medication management tools like reminders and auto refills  in our app. And our team of pharmacists are always here to answer your questions by phone or through our app, and will even remind you when your medications are due for a refill.

Reach out any time to get started by phone at 1-800-874-5881 or download the app for secure messaging!

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Heart-healthy living is a lifelong practice. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life.

How to Prevent Heart Disease at Any Age

You may associate heart disease with aging, and for good reason — individuals age 65 and older face a higher risk for the condition. This stems in part from how aging-related changes in your body overlap with risk factors for heart disease. For example, your arteries and heart muscle stiffen with age, making it more difficult to pump blood well during exercise.

Still, it’s never too early to prioritize a heart-healthy lifestyle. As heart disease-linked conditions like diabetes and high blood pressure grow increasingly common among young adults, many people are now becoming at risk for heart disease at an earlier age. 

And even if you are young and in good overall health, the choices you make today can affect your heart health for years to come. Cardiovascular health issues like heart attacks, strokes, and heart failure often stem from a lifetime’s worth of health choices, including many you have control over.

Since heart-healthy living is a lifelong practice, it may feel more manageable if you set specific goals and priorities impactful for your age group. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life. This is intended to be a high-level guide to prevention, so consult with your healthcare provider about more targeted priorities based on your individual health needs.

2. Search for a primary care provider if you don’t have one

3. Find your favorite physical activity and develop a fitness routine

You’re out in the real world, exploring what you want your life to look like. It’s normal to experience some anxiety during this exciting but nerve-racking time. Your cardiovascular health may not be top of mind as you navigate a stressful job search, adjust to the pressure of beginning a career, or start a family, but taking several heart healthy actions during this decade of life will put you on the right track early on.

Focus on building a foundation for a healthy lifestyle. That means quitting smoking if you currently smoke, figuring out which physical activities work for you, and getting in the practice of staying up to date with yearly doctor’s appointments. If you don’t already have a primary care provider, now’s the time to search for one.

1. Create a weekly routine that makes time for exercise

2. Prioritize your mental health — whatever that looks like for you

3. Contact relatives to build your family medical tree

There’s a good chance your calendar’s looking pretty packed these days. Momentum in your career may come with more responsibilities and later nights in the virtual or physical office. And for those who already have a family, or are thinking of starting one, maintaining work-life balance may be a challenge.

As you continue to build on the foundation you set in your twenties, here are three new action items to add to your health routine. First, remember your favorite physical activity? Make sure there’s a block of time in your schedule for it each week.

Since your mental health can significantly impact your physical health — and your risk for heart disease in particular — be sure to give your emotional well-being some attention during what may be a hectic time. 

Some stress is to be expected when you have many responsibilities at work or home (or both), but if you’re concerned about your mental health, don’t be afraid to ask your doctor for suggestions or resources. You can also check out Moodfit, a free mood-tracking app, or Insight Timer, an app that offers free guided meditations.

Lastly, since your family’s health history is a big predictor of your own risk for cardiovascular disease, take some time to contact relatives and figure out if heart health issues run in your family tree.  

1. Continue to explore your exercise options

3. Stay current with annual check-ups and screenings

Does it feel like life has only gotten faster? Believe it or not, your metabolism has already begun to slow down. That means it’s time to amp up your workout routine, if you haven’t already. Enjoying your chosen exercise method is key to sticking with it in the long term, so if you haven’t found your go-to activity just yet, keep looking. If you’ve only ever worked out on your own, try a group class, online or in person.

It’s time to check in on your sleep hygiene, too. Regular sleepless nights have been linked to heart attacks, high blood pressure, and diabetes, so if you’re getting in less than an average of seven hours every night, try to set yourself up for a good night’s sleep. Winding down at the same time each night, avoiding heavy meals just before bed, and spending plenty of time outside are just a few of the simple steps that might be able to help you get more rest.

At your annual physicals, be sure to discuss your risk for heart disease with your doctor and ask about recommended screenings for your individual health needs, including a fasting blood glucose test to screen for diabetes.

2. Limit your sodium and cholesterol intake

3. Learn the warning signs of a heart attack

Your risk for high blood pressure and high cholesterol will continue to increase as you age, so it’s important to keep track of your blood pressure, cholesterol, and blood glucose levels. If you have high blood pressure or cholesterol, follow the treatment plan your doctor has recommended, which may include diet changes, medication, or a combination of both. Even if your blood pressure and cholesterol numbers are within a healthy range, you can only benefit from limiting your sodium and cholesterol intake.

You should also learn the warning signs of a heart attack, as your risk for one also increases with age: 65 is the average age of a first heart attack for a man, and 72 is the average age of a first heart attack for a woman.

Keep in mind that heart attack symptoms may appear differently in women than in men.

Remember, these suggestions are intended as a starting point. Your doctor can advise you on a more individualized plan of action based on your health history. And not only is it never too early to begin prioritizing heart disease prevention, but it’s also never too late. Don’t worry about what you should or could have done earlier in life — instead focus on the actions you can take to be as healthy as possible in the present.

Staying physically active and avoiding foods that are high in sodium and trans fats are simple ways to take charge of your health at any stage of life. Here are more specific suggestions for heart-healthy living in terms of diet and exercise.

As you plan a heart-healthy diet, opt for foods that are low in saturated fats and trans fats, which increase levels of low-density lipoproteins (LDL) cholesterol — also referred to as “bad cholesterol” — in your blood. Low-fat dairy products and chicken are healthier alternatives to full-fat dairy products and red meats, which are high in saturated fats.

High sodium intake can increase your blood pressure, and the American Heart Association suggests aiming for 1,500 mg of sodium/day. Limit processed or prepackaged foods including soups, cold cuts, bread, and frozen meals since they contain sodium-based preservatives. And watch out for compounds that contain sodium as you scan the ingredient list, like sodium benzoate and sodium tripolyphosphate.

Regular exercise can help you maintain a healthy weight and keep your blood pressure, cholesterol, and blood sugar levels in a healthy range. Different activities offer various levels of intensity, and there are a variety of ways to get the American Heart Association’s recommended amount of aerobic activity . You should aim for about 150 minutes a week of moderate-intensity aerobic activity, like brisk walking, or 75 minutes a week of a more intense activity. Many people start off slower and build their way up to a more intense routine.

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications. We offer free same-day delivery and medication management tools like reminders and auto refills in our app. And our team of pharmacists is always here to answer your questions by phone or chat, and will even remind you when your medications are due for a refill.

Reach out any time by phone at 1-800-874-5881 or in-app messaging.

How to Prevent Heart Disease at Any Age 

When there are issues with your heart’s electrical signals it may beat too quickly, too slowly, or irregularly. This is called an arrhythmia. Learn more about the primary types of arrhythmias and the medications most commonly used to treat them.

Medications Commonly Used to Treat Arrhythmias

While a resting heart rate — the number of times your heart beats per minute when you’re at rest — will vary from one individual to the next, the healthy range for an adult is between 60 and 100 beats per minute. However, when there are issues with your heart’s electrical signals, which trigger each individual heartbeat, your heart may beat too quickly, too slowly, or irregularly. This is called an arrhythmia.

The best course of action depends on the type of arrhythmia you have and your overall health. Many cases of mild arrhythmias do not require any treatment. But your doctor may recommend medication to control or resolve your arrhythmia if there is a risk that your arrhythmia could cause more serious heart health issues.

Below, we explain more about the primary types of arrhythmias and the medications most commonly used to treat them.

Arrhythmias are categorized by the speed of the resulting heart rate and the area of the heart in which they originate.

A tachycardia is a fast heart rate, typically over 100 beats per minute when you’re at rest. There are many different types of tachycardias, including the following:

Atrial fibrillation is a rapid heart rate caused by irregularities in the electrical signals in the heart’s upper chambers, or atria. The condition may be temporary in some cases, but it often requires retreatment. It has been linked to more serious health issues including strokes.

Ventricular tachycardia is a rapid but steady heart rate caused by irregular electric signals in the heart’s lower chambers, or ventricles. The condition may lead to health complications depending on your overall cardiovascular health.

A bradycardia is a slow heart rate, typically under 60 beats per minute when you’re at rest. There are several types of bradycardias, including:

Sick sinus syndrome is a condition in which your sinus node — the heart’s natural pacemaker — doesn’t properly send electrical signals, causing your heart rate to beat slowly. (In some individuals, sinus node problems may result in a heart rate that alternates between too slow and too fast, which is also called bradycardia-tachycardia syndrome.)

Heart block, or atrioventricular block, is a condition in which electrical signals running through the atria don’t reach the ventricles. There’s a wide range in the severity of heart blocks, so they are subclassified into first-degree (mildest), second-degree, and third-degree (complete) heart blocks.

It’s also possible to experience a premature heartbeat, which often feels like a skipped heartbeat but is actually an additional beat. Premature heartbeats may occur when you are at rest, or they may be caused by stress, physical exertion, or stimulants like caffeine or nicotine.

For many individuals, premature heartbeats do not lead to more serious health problems, but it may trigger a more persistent arrhythmia in others. If you have a preexisting heart disease, you are more likely to experience complications as the result of a premature heartbeat.

Monitoring your heart rate and diagnosing an arrhythmia

Regularly monitoring your heart rate and heart rhythm can help you identify any potential issues in advance and avoid more serious health complications. Read our previous blog, ‘What Your Heart Rate Can Tell You About Your Health’ for additional guidance on measuring your resting heart rate. And if you have any concerns about your heart rate, consult with your doctor for an evaluation of any heart-related health issues.

To make a formal diagnosis of an arrhythmia, your doctor may use one or more tests to capture your heart’s rhythm. The process often begins with an electrocardiogram (ECG), a test performed in your doctor’s office in which patches attached to various places on your chest, arms, and legs record your heart’s activity.

If you have a chronic, consistent arrhythmia, the ECG may accurately capture your arrhythmia. However, if your arrhythmia is less frequent, an ECG may not necessarily give your doctor the information needed for a diagnosis. If that’s the case, they may recommend additional tests, including monitors you can use at home to record your heart’s activity over a longer period of time.

Treating an arrhythmia with antiarrhythmics

Antiarrhythmics help restore a regular heart rhythm by acting on the electrical currents that cause your heart to beat. They are most commonly used to treat tachycardias or premature heartbeats, and the majority are taken orally as a pill on an ongoing basis.

These are some of the most commonly prescribed antiarrhythmics and their side effects:

Amiodarone works by slowing down your heart’s nerve activity. It will likely take several weeks of amiodarone use before you experience the medication’s full effects.

It isn’t uncommon to experience nausea, vomiting, constipation, loss of appetite, abdominal pain, or a combination of these effects from taking amiodarone. For that reason, your doctor may recommend that you take amiodarone with meals.

Additional side effects include tremors, lack of coordination, weakness, fatigue, and difficulty sleeping. If any of these are severe or long-lasting, or if you experience more serious side effects such as abdominal swelling or painful breathing, contact your doctor right away.

Flecainide is typically started in the hospital if you are admitted for an arrhythmic-related health issue so that your doctor can closely monitor your response to it. It comes in tablet form and is usually taken twice a day. If you experience an upset stomach from the medication, your doctor may recommend that you take it with food or milk.

Flecainide is most effective when there is a constant level of it in your bloodstream so it’s important that you take it exactly as directed by your doctor. Abruptly stopping use of flecainide can cause serious health complications, so be sure to follow your doctor’s recommendations and consult with them if you have any concerns.

Common side effects of flecainide include nausea, vomiting, or diarrhea; loss of appetite; tremors; blurred vision; sleep disruptions; weakness; and dizziness or faintness. Contact your doctor if these side effects are severe or long-lasting. If you experience any severe side effects such as chest pain, yellow eyes or skin, fever, or difficulty breathing, contact your doctor as soon as possible.

Standing up slowly from sitting or lying down can alleviate dizziness and drowsiness caused by the medication. You should also ask your doctor if there are any activities to avoid while taking this medication given these side effects.

Propafenone acts on the heart muscle to improve your heart rhythm. It is typically taken three times a day. You may begin taking it in the hospital so that your doctor can observe how it affects you.

To maintain a consistent level of propafenone in your bloodstream, it’s important to follow your healthcare provider’s recommendations and to take the medication exactly as prescribed. If you have any concerns about taking this medication, consult with your doctor, as abruptly stopping use of propafenone may lead to an irregular heartbeat. One exception is if you experience excessive drowsiness or a slow or irregular heartbeat, in which case you should stop taking the medication right away and contact your doctor.

Side effects are less common with propafenone than with other antiarrhythmics. However, you may experience nausea, vomiting, constipation, diarrhea, loss of appetite, stomach cramps, weakness or muscle aches. Contact your doctor if you have any concerns about these side effects.

Ask your doctor about any possible food restrictions or necessary changes to your diet, as potassium can interact with propafenone.

Dronedarone is primarily recommended for individuals who have previously had atrial fibrillation but now have a normal heart rhythm. It can reduce the likelihood of being hospitalized for the condition in the future.

Your doctor will likely consider your overall health when determining if dronedarone is a good fit for you, as the medication may increase your risk for complications of other heart conditions. It is not typically recommended for individuals who have severe heart failure or worsening heart failure symptoms, or if your atrial fibrillation has remained consistent.

This medication has been known to interact with other medications, including other heart rhythm medications; antiviral medications like ritonavir; certain antibiotics including clarithromycin and telithromycin; certain antidepressants including amitriptyline, clomipramine, and nefazodone; antifungal medications like itraconazole, ketoconazole, and voriconazole; and antipsychotic medications like chlorpromazine, fluphenazine, and thioridazine. Make sure your doctor is aware of any medications you take.

Antiarrhythmics may also be administered intravenously in the hospital during a medical emergency. Ibutilide (Corvert®) and lidocaine (Xylocaine®) are two of the most commonly used antiarrhythmics that are administered through an IV.

General guidance about antiarrhythmic use

There are some general practices to follow when taking any medication in this class to avoid more serious health complications and manage side effects:

Inform your doctor of any underlying health conditions you have, as these may interact with your medication, especially kidney disease, congestive heart failure, liver disease, diabetes, or respiratory disease.

Your doctor may recommend exams, electrocardiograms (ECGs), and blood tests to monitor the medication’s effectiveness. Stay current with these follow-up appointments and lab work. 

Use caution when driving, particularly while you are still adjusting to the medication, and ask your doctor if there are any activities that you should avoid.

Depending on the type of arrhythmia you have and your overall health history, your doctor may also recommend calcium channel blockers or beta blockers. Here’s what to know about these medication classes.

If you have chest pain or high or low blood pressure in addition to your arrhythmia, your doctor may prescribe a calcium channel blocker. Commonly used to treat high blood pressure, calcium channel blockers open up narrowed blood vessels, allowing for more blood to flow to your heart. They are also used to treat arrhythmias since the opening of blood vessels can also slow your heart rate.

Most calcium channel blockers prescribed for arrhythmias are taken orally as pills, but some of them may be taken intravenously, which is when a medication is sent directly into your veins using a needle or a tube, typically in a hospital or doctor’s office.

Calcium channel blockers commonly used to treat arrhythmias include:

Common calcium channel blocker side effects include dizziness, constipation, and headaches. More severe side effects include rash or swelling in your legs and feet. Contact your doctor if you have any concerns about these side effects.

Beta blockers are commonly used to treat high blood pressure. Since they cause the heart to beat more slowly and less forcefully, they are also effective at treating tachycardias.

Beta blockers commonly used to treat tachycardias include:

Common beta blocker side effects include cold hands, fatigue, headache, and weight gain. They may also affect your digestive system.

If you have diabetes and take insulin, it’s important to check your blood sugar levels often while taking beta blockers as beta blockers may block typical signs of low blood sugar such as a rapid heart rate. Beta blockers are not typically used by people with asthma, as they may trigger severe asthma attacks.

If your arrhythmia puts you at a greater risk for blood clots or a stroke caused by a blood clot, your doctor may add an anticoagulant to your medication protocol. These medications reduce the blood’s ability to form new blood clots and prevent existing clots from growing. They will not address your arrhythmia, however, so they are typically taken in combination with one of the medications described above.

Choose a pharmacy that never skips a beat

At Alto, we’re committed to making it as simple as possible to manage your arrhythmia and strengthen your heart. We offer free same-day delivery and medication management tools like reminders and auto refills in our app. And our team of pharmacists is always here to answer your questions by phone or through the Alto app, and will even remind you when your medications are due for a refill.

Reach out any time via phone at 1-800-874-5881 or in-app messaging.

Pharmacist discussing medication with patient

Evidence suggests that gut health may also belong on the list of heart disease risk factors. Here’s what to know about the link between heart health and gut health, including steps you can take to maintain a balanced gut microbiome.

What to Know About the Heart and Gut Health Connection

Different factors can increase your chance of developing heart disease, like age, family history, high cholesterol, and high blood pressure, among others. And now, evidence suggests that gut health may also belong on the list of heart disease risk factors.

There are trillions of bacteria, fungi, and other small, microscopic organisms called microbes housed in your digestive system. They are collectively referred to as the gut microbiome. In recent years, researchers have found that the gut microbiome affects more than your digestive health alone. Heart disease is one of several health conditions that may be at least partially fueled by an unhealthy balance of gut bacteria.

The good news? This is a heart disease risk factor you definitely have control over. Here’s what to know about the link between heart health and gut health, including steps you can take to maintain a balanced gut microbiome.

Metabolites and your cardiovascular system

During the digestive process, microbes produce substances called metabolites. One of these substances in particular, trimethylamine (TMA), is linked to your risk for cardiovascular disease and other chronic health conditions like diabetes.

TMA forms when the bacteria and other organisms within the gut microbiome consume choline, a nutrient contained in red meat, fish, poultry, and eggs. The liver then converts TMA into a substance called trimethylamine N-oxide (TMAO). 

The medical community has identified a connection between high levels of TMAO in your blood and deposits of cholesterol, blood-clotting material, and other substances in your arteries. These substances are collectively referred to as plaque, and its accumulation in your arteries is referred to as atherosclerosis, a leading cause of cardiovascular disease, heart attacks, and strokes.

A 2017 analysis of several studies on the connection between TMAO blood levels and cardiovascular health found a correlation between elevated TMAO levels and serious cardiovascular issues. In the studies, researchers looked at people from different categories of health conditions in multiple countries, like individuals with and without diabetes, and individuals with and without chronic heart failure. 

Each group included individuals with various TMAO levels. The results showed that people with the highest levels of TMAO were 62% more likely to experience serious cardiovascular issues like heart attacks and strokes. The link appeared to be independent of other key risk factors for heart disease like diabetes and obesity.

In addition to the findings about TMAO, researchers have also identified a link between gut health and inflammation (redness, warmth, and swelling around tissues and joints). Inflammation is part of the body’s natural response to an injury, but when it persists after the healing process and becomes chronic inflammation, it can lead to an ongoing high white blood cell count.  

Over time, this elevated level of white blood cells can affect other organs including your heart, lungs, and kidneys, which may influence your risk for heart disease and other chronic conditions like diabetes.

The majority of the body’s inflammatory cells are stored in tissues in your gut, and researchers have found that an inflamed gut can trigger inflammation elsewhere in your body. Certain gut bacteria produce substances that enter your bloodstream and create inflammation in every part of the body that they travel through. This inflammation in the walls of your blood vessels can eventually lead to atherosclerosis.

Researchers are still learning about the gut microbiome’s influence on your risk for various health conditions. One thing they do know for sure is that a healthy gut microbiome is an important component of your overall health, and there are simple steps you can take to maintain a balanced digestive system.

A balanced diet is a great starting point for better gut health. Start by limiting foods that are processed or high in sugar or fat — particularly cookies, sugary drinks, salty snacks, and frozen foods — as these can lead to increased inflammation. Opt for fiber-rich foods like beans, peas, bananas, and asparagus; fermented foods like kimchi, yogurt, miso, and kefir; and collagen-rich or collagen-boosting foods like salmon, mushrooms, and egg whites.

Staying physically active and avoiding unhealthy habits like smoking and heavy alcohol consumption can also improve your gut health. Looking for a fitness routine that fits your schedule and health needs? Aim for about 150 minutes a week or 30 minutes per day. Explore different activities until you find the one that’s right for you — whether virtually or in person.

Over the long term, stress can lead to many physical and mental health problems, including digestive issues. Staying physically active reduces stress, so you’re already tackling this risk factor simply by working out regularly.

Beyond exercise, check out Insight Timer, an app that offers free guided meditations or Moodfit, a free mood-tracking app. And since there’s an established link between stress and high blood pressure, heart disease, and stroke, these small actions can benefit several aspects of your health at once!

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications.  We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly

Reach out any time by in-app secure messaging or phone at 1-800-874-5881. 

A consistent lack of sleep can also affect your physical and mental health in the long term. Here's what you can do to improve your sleep hygiene.

How Sleep Affects Heart Health | Alto Pharmacy

If you’ve ever slept less than the CDC-recommended minimum of seven hours per night, you may have experienced short-term effects of sleep deprivation like forgetfulness, irritability, and an inability to focus. A consistent lack of sleep can also affect your physical and mental health in the long term. And just like diet choices and frequency of physical activity, your sleep habits are linked to your risk for heart disease.

Below, we explain more about how sleep affects heart health and what you can do to improve your sleep hygiene.

Sleep allows your body to recharge. As you enter a state of deep sleep, your heart rate slows down and your blood pressure drops. These physical changes give your heart a chance to recover from how hard it works when you’re awake.

When you don’t spend enough time in uninterrupted deep sleep, your heart doesn’t get the opportunity to rest. Research has found that chronic sleep deprivation and sleep disorders can contribute to numerous cardiovascular health issues including high blood pressure, high cholesterol, and a greater risk for a heart attack or stroke.

Cardiovascular health issues related to sleep

Over time, many sleepless nights can lead to higher baseline blood pressure levels during the day. High blood pressure, or hypertension, is among the leading risk factors for heart disease and stroke. If you experience consistent stress or if you have other risk factors for high blood pressure, you may be more likely to develop high blood pressure as a result of sleep deprivation.

Poor sleep may also contribute to these cardiovascular health issues:

Coronary artery disease occurs when cholesterol and other fatty material (collectively referred to as plaque) builds up in your arteries, making it harder for your heart to pump blood to the rest of your body. This accumulation of plaque is also called atherosclerosis.

Some research has found that a lack of sleep may contribute to atherosclerosis. This is partially due to the connection between sleep deprivation and hypertension, as high blood pressure strains your arteries. In addition, poor sleep can trigger chronic inflammation over time, which also contributes to the accumulation of plaque and the hardening of your arteries.

Chronic sleep deprivation may also increase your risk for a heart attack. One research study found that people who slept less than six hours per night had a 20% higher risk of a heart attack in comparison to those who got more sleep.

While your heart slows down when you are in a state of deep sleep, your heart rate and blood pressure can increase if you wake up suddenly. Over time, consistent sleep disruptions can put greater stress on your heart and contribute to your overall heart attack risk.

A stroke is a cardiac event in which blood flow to your brain is interrupted, causing brain cells to die. Because sleep deprivation can drive high blood pressure and plaque accumulation in your arteries — two leading risk factors for strokes — there is also a correlation between a lack of sleep and your risk of having a stroke.

Type 2 diabetes is a condition in which your body’s cells become resistant to insulin, and your pancreas cannot produce enough insulin to regulate levels of blood glucose. It develops gradually due to a mix of genetic, lifestyle, and environmental factors.

Research has linked poor sleep to prediabetes, a health condition defined primarily by blood sugar levels that are higher than normal but below the official range for a type 2 diabetes diagnosis. If left untreated, prediabetes can progress into type 2 diabetes and lead to health complications in the long term, including cardiovascular issues.

If you already have diabetes, a lack of sleep or frequently interrupted sleep may also impact blood sugar management.

There are two primary sleep problems that can impact your long-term cardiovascular health: sleep apnea and insomnia.

Sleep apnea is a disorder in which your airway is blocked during sleep, which causes you to stop breathing for short periods of time. It affects your oxygen levels while sleeping and may increase your risk for high blood pressure, heart attack, and stroke.

Insomnia is when you have trouble going to sleep or staying asleep. Many individuals have experienced insomnia in the short-term, and the CDC estimates that 1 in 10 U.S. adults may experience chronic insomnia.

More than 1 in 3 adults in the U.S. report getting less than the recommended seven hours of sleep per night. The good news is there are steps you can take to improve your sleep hygiene. Start with the following:

Maintain a consistent sleep schedule, going to bed and waking up at the same time every day, including weekends.

Avoid use of electronic devices close to your bedtime.

Get plenty of natural light and stay physically active during the day, but avoid exercising close to bedtime.

Avoid consuming food or beverages close to bedtime, particularly caffeine, alcohol, and high-sugar or high-fat foods.

Keep your bedroom dark and quiet and maintain a comfortable temperature. 

Read our previous blog for strategies that can help you avoid stress-related sleep problems..

If you think you may have a sleep disorder, you should also consult with your doctor for a diagnosis and treatment, in addition to taking the actions above.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

How Sleep Affects Heart Health & Tips for Better Sleep

Prioritizing your heart health becomes even more important during the holiday season. The good news? A little self-care goes a long way, and even small actions can have a big impact on your physical and mental well-being. Here are simple ways to keep your heart healthy this holiday season

How to Keep Your Heart Healthy During the Holidays

Prioritizing your heart health becomes even more important during the holiday season. Not only is it more difficult to maintain your typical exercise routine and healthy habits amid the shopping, traveling, and hosting, but the seasonal stress can also put more strain on your heart. The good news? A little self-care goes a long way, and even small actions can have a big impact on your physical and mental well-being. Here are simple ways to keep your heart healthy this holiday season.

Stress can increase your risk of heart disease both directly and indirectly. It increases inflammation, which is linked to high blood pressure, and can also lead to sleep deprivation or disruption, another risk factor for heart disease.

As you plan for heart-healthy holidays, identify potential sources of stress in advance and look for opportunities to limit it. Some degree of holiday stress is bound to occur, but try to avoid overextending yourself by setting priorities and limiting how much you take on.

Throughout the season, watch for the emotional, physical, and behavioral symptoms of stress. Each individual experiences stress differently, but common signs include headaches, chronic pain, decreased energy, changes in appetite, digestive issues, and depression.

If you find yourself feeling overwhelmed, seek out positive outlets for stress relief, like mindfulness, meditation, and exercise. Simply pausing to take a breath on a busy day can help counteract the physical effects of stress: in signaling the brain to calm, deep breathing can lower your heart rate and blood pressure.

In addition, here are some apps that can help you proactively manage stress and anxiety this holiday season:

Insight Timer, which offers a variety of free guided meditations

What’s Up?, which uses a cognitive behavioral therapy (CBT) approach to managing stress and negative thoughts

It may seem difficult to maintain a heart-healthy diet during the holidays: sodium — which can lead to high blood pressure — and trans fats — which increase your blood levels of “bad cholesterol” — are found in many popular seasonal dishes.

Prioritizing your heart health during the holidays doesn’t mean avoiding your favorite foods altogether, but rather trying to strike a balance. If you’re preparing food for holiday celebrations, look for small ingredient swaps that can transform a dish into a heart-healthy recipe. The American Heart Association has a list of holiday recipe hacks like swapping Greek yogurt for sour cream and applesauce for butter, and cooking with low-sodium or frozen vegetables.

The importance of moderation also applies to drinking, as increased alcohol consumption over the holidays can also impact your heart health. In the long term, heavy alcohol use — defined by the CDC as 8 or more drinks per week for a woman and 15 drinks or more for a man — may increase your risk for high blood pressure, heart failure, and stroke. In the shorter term, experiencing an increased heart rate as the result of drinking heavily during holiday celebrations is sometimes referred to as “holiday heart syndrome.”

Get creative with making time for exercise

It’s great to set New Year’s fitness goals, but that doesn’t mean November and December are a time to step back from your exercise routine. Regular physical activity lowers your risk for heart disease, and it’s especially important to stay active during the holidays in light of the added stress and opportunities to overindulge.

If you’re struggling to carve out time for exercise amid the hectic holiday season, get creative with how you fit exercise into your day. While it’s generally good to aim for about 30 minutes of exercise per day, your heart will benefit from even a quick 15 or 20-minute workout. Look for opportunities to fit in quick bursts of physical activity. Doing an extra lap at the mall while holiday shopping or taking the stairs instead of the escalator counts! Other daily activities that will get your heart pumping? Gardening or shoveling snow, depending on where you live, or going for more frequent walks with family.

And if you’re looking for easy ways to get in exercise during your holiday travels, browse free online workouts or try travel-friendly exercises like push-ups, planks, walking lunges, or jumping jacks.

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As steady as a heartbeat.

We're specialists in medication for:

Hypertension (High blood pressure)

Hyperlipidemia (High cholesterol)

Anticoagulants and antiarrhythmics

"I have about 20 medications that I take... the SmartPack and door delivery, it's made a considerable difference in my life."

From Our Blog

How to Keep Your Heart Healthy During the Holidays

How Sleep Affects Heart Health & Tips for Better Sleep

What to Know About the Heart and Gut Health Connection

Medications Commonly Used to Treat Arrhythmias

How to Manage High Cholesterol: Diet, Medications, and More

How to Prevent Heart Disease at Any Age

Ask your pharmacist, not the internet.

Courier delivery right to your door.

FAQs

How does Alto work?

Do you carry my medication?

Will I be covered by my insurance?

Switch to a better pharmacy.