High cholesterol is one of a number of risk factors, but not actually an illness in itself. So treatment shouldn't only aim to lower the person's cholesterol levels. It is important to take their overall cardiovascular (heart and blood vessels) health into account.
There are lots of things we can do on our own to avoid poor cholesterol levels and keep our cardiovascular system healthy. They include the following:
- Not smoking
- Reducing the amount of saturated fats and trans fats in your diet
- Getting enough exercise
- Losing a little weight if you're very overweight
- Eating a low-salt diet if you also have high blood pressure
People who have a significantly increased risk of cardiovascular disease, due to a coronary heart disease for example, can benefit from medication that reduces cholesterol levels. But the benefits for people who don't have a cardiovascular disease are limited – especially if they only have high cholesterol but no other risk factors for instance. So it's a good idea to talk to your doctor about the advantages and disadvantages. Ultimately, it's up to you whether you want to take medication as a preventive measure.
If you do decide to take medication, you'll be prescribed statins. Of all options available, most research has been done on statins. The findings show that they can lower the risk of cardiovascular diseases and increase life expectancy. They are also well tolerated by the vast majority of people.
People who've already had a heart attack, stroke or other cardiovascular disease have a high risk of developing further heart problems. So statins are a recommended treatment for them as well as for people who have familial hypercholesterolemia.
There is no proof that dietary supplements containing omega-3 or omega-6 fatty acids provide protection against cardiovascular disease. But there is evidence that fish oil capsules containing omega-3 fatty acids can increase the risk of an irregular heartbeat (atrial fibrillation). As a result, some experts now advise against taking them.
Please note that, when considering the benefits of medication, it isn't enough to look at how they affect cholesterol levels. Treatments can only be considered well tested if researchers have also looked at whether they actually prevent heart disease.