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High cholesterol level is a risk factor for heart disease. However, it can be controlled by using a combination of treatments which include a healthy diet, regular exercise, lifestyle changes and medications. Adults who are at risk should seek medical consultation for proper diagnosis and treatment of this condition. The treatment of this condition involves medical and lifestyle interventions.

Diet - The first step in treating high cholesterol involves a change in lifestyle that includes healthy diet and regular exercise. Just losing 5 to 10 extra pounds can help reduce cholesterol levels. A healthy diet should include cholesterol-lowering foods such as:

• Whole grain products
• Fruits and vegetables
• Some types of fatty fish
• Monounsaturated fat - from olive, canola and peanut oils
• Skim milk, lean cuts of meat, and egg substitutes

One should avoid fatty and sugary foods, saturated fat and trans fat which can raise the total cholesterol LDL (bad cholesterol) and triglyceride levels.

Exercise - Spending 30 to 60 minutes a day in moderate exercise helps lower cholesterol levels.

Smoking and Alcohol - To improve cholesterol levels, one should stop smoking and avoid drinking large amounts of alcohol.

Medications - Doctors may prescribe certain medicines or a combination of medications, depending on various factors, such as age, current health status, individual risk factors and possible side effects. These medications include:

1. Statins - These are cholesterol lowering drugs that block the production of cholesterol in the liver, facilitate its removal from the blood and help in its reabsorption from the walls of the arteries, thus preventing coronary artery disease. Examples are:
   • Atorvastatin (Lipitor)
   • Fluvastatin (Lescol)
   • Lovastatin (Altoprev, Mevacor)
   • Pravastatin (Pravachol)
   • Rosuvastatin (Crestor)
   • Simvastatin (Zocor)
2. Cholesterol absorption inhibitors - These medications limit the absorption of cholesterol from the foods in the intestine, such as Ezetimibe (Zetia).
3. Bile-acid resins - These medications work by binding to bile (which is made from cholesterol), thus depleting the body's source of cholesterol. Examples are:
   • Cholestyramine (Prevalite, Questran)
   • Colesevelam (Welchol)
   • Colestipol (Colestid)
4. Combination drugs - Ezetimibe-simvastatin combination (Vytorin) decreases both the absorption of cholesterol from the small intestine and production of cholesterol in the liver.
5. Fibrates - These drugs decrease blood triglycerides by reducing the production of VLDL cholesterol in the liver. VLDL contains mostly triglycerides. Fibrates also remove triglycerides from the blood. Examples include:
   • Fenofibrate (Lofibra, Tricor)
   • Gemfibrozil (Lopid)
6. Niacin - Prescription Niacin (Niaspan) reduces triglycerides by decreasing the liver's ability to synthesized VLDL and LDL cholesterol.
7. Omega 3 fatty acid supplements - These supplements can help lower bad cholesterol and increase good cholesterol.