Once testing has revealed that a patient has unhealthy cholesterol levels, a physician will devise a treatment plan. Lifestyle modification strategies are usually the first line of treatment.

If the test showed an elevated level of LDL (“bad”) cholesterol, the physician will recommend healthier diet choices, such as avoiding fatty and processed foods. Patients are also frequently advised to increase their level of physical activity. If diet and exercise strategies are unsuccessful in reducing LDL cholesterol, one or more cholesterol reducing drugs may be prescribed. It is important to lower an elevated LDL cholesterol level because high levels put a person at a greater risk of atherosclerosis, coronary artery disease and other heart-related conditions.   

There are five main categories of cholesterol reducers:

• Statins. Block the production of specific enzymes used by the body to make cholesterol. These are considered the first line of treatment most patients with high cholesterol (hypercholesterolemia).
  
  
• Bile acid resins. Block the recycling of bile acids. This forces the liver to remove more cholesterol from the blood in order to manufacture bile.
  
  
• Nicotinic acid (niacin). A form of vitamin B3 found naturally in meat, eggs and dairy products. It is also available as an over-the-counter supplement.
  
  
• Fibrates (or fibric acid derivatives). Reduce the production of triglycerides and increase the rate at which existing triglycerides are removed from the bloodstream.
  
  
• Ezetimibe. Directly block cholesterol absorption in the small intestine.

These drugs may also be recommended to raise HDL (“good”) cholesterol levels. However, medications are usually not prescribed unless other strategies have proven unsuccessful. Physicians will first recommend that patients make dietary changes, such as eating monounsaturated fat (in moderation), and start a regular exercise program. Patients may also be advised to achieve and maintain a healthy weight, quit smoking and limit alcohol consumption. Patients should strive for high HDL cholesterol levels because HDL has been shown to have a protective effect on cardiovascular health.  

Many of the lifestyle modifications used to improve LDL and HDL levels are also used to lower triglyceride levels. Cholesterol reducing drugs may also be prescribed as a last resort.   

Although research has not demonstrated that lowering triglyceride levels will necessarily lead to improved heart health, the strategies recommended for lowering triglyceride levels are all heart-healthy, and many result in an improved cholesterol ratio.