Around 33% to 36% of adults in the U.S. have a bad LDL cholesterol level of 130 mg/dL or higher, putting them at risk for a heart attack, stroke, peripheral vascular disease, and dementia.

Aiming for 70 mg/dL is heart-smart. But only around 20% of patients at high risk of heart disease manage their LDL, often because they don't want to take a statin or it didn't do the job.

Now comes another solution.

The Cleveland Clinic just announced the results of a phase 3 clinical trial that combined the approved cholesterol medication ezetimibe (brand name Zetia) — which works by preventing absorption of cholesterol in your gut — with a new medication called obicetrapib, which not only lowers LDL levels, it also boosts good HDL cholesterol.

The study enlisted people who could not achieve a healthy LDL cholesterol level even when taking a statin. After three months of using the new two-drug therapy, they cut the levels by almost 49%.

That offers dramatic protection to high-risk people, so stay tuned for news about availability.

In the meantime, consider taking a multi-vitamin/mineral (half in the morning, half at night), psyllium fiber, and omega-3 fatty acid supplements (900 mg per day). You should also enjoy salmon and get seven daily servings of different colored vegetables and fruits, and dodge heart-damaging red and processed meats and added sugars.

In addition, get 30-plus minutes of physical exercise daily, mixing up strength-building with aerobics.

For anyone with familial hypercholesterolemia, therapeutic plasma exchange has been shown to substantially reduce blood lipid levels.