Hi Thank you for asking HCM I have gone through your query.Metabolic diseases like hypothyroidism and diabetes is associated with high cholesterol.So you should rule out those by doing TSH and blood sugar level.It can also occur in poor diet like with high saturated fat and trans fat consumption decrease in exercise and even family history.If you are free of thyroid problems or diabetes then you can do life style modification for 1 month.You can have exercises like jogging of at least 8 km per hour or swimming or other exercises which may help.If there is not much change then it is better to start statin therapy.I usually give a low dose statins initially.Hope this may help you. Let me know if you have any further query.