January 17, 2010:
According to current national guidelines in many countries, the first thing your doctor is supposed to do to treat high LDL cholesterol is to recommend lifestyle changes that includes dietary counseling. If that is ineffective then drug treatment is the next option. You should still try to maintain the recommended lifestyle changes while taking drug treatment since this can have other benefits such as promoting weight loss, improving blood glucose levels and improving blood pressure control.
People with a true genetic predisposition for high LDL cholesterol, which is thought to affect about 1 in 500 people, may find it impossible to reduce cholesterol levels through diet and may also find some drugs ineffective. There can be a lot of trial and error until the right solution to their cholesterol problem is found.