Diet and exercise is the first thing the docs want you to try. If you are overweight, they will suggest a 10% weight loss. As for diet, they will suggest a low-fat high fiber diet. These are called lifestyle interventions and are usually used first. If you are diabetic, have a family history of heart disease, or are of black or of hispanic descent, the docs will prescribe a lipid-lowering agent without waiting for lifestyle changes to happen. If you don t control cholesterol you are at a great risk for heart attack, stroke, and peripheral artery disease. For more info, the American Heart Asso. has a great websight and in-depth answers to your question.