Having high levels of blood cholesterol is a medically established risk factor for heart disease (and consequently, early death). Therefore lowering your cholesterol to acceptable levels is unquestionably a good move and there are basically two ways to achieve this: first adopt a set of specific lifestyle changes and second take cholesterol lowering drugs.

In general, modern lifestyles are the root of much of the hyper-cholesterolemia (as high cholesterol is medically termed) so prevalent these days and in Western societies especially. As a result, it is relatively easy to address the problem with quite modest changes to diet and exercise.

That said though, there are individuals who either inherit a genetic disorder (familial hyper-cholesterolemia) or have allowed their cholesterol levels to get so high that diet and exercise alone are not enough. They are normally prescribed cholesterol lowering drugs called statins - once their condition is recognised of course, which is why the importance of testing cholesterol levels these days cannot be stressed enough.

Before we get into further detail about these two strategies (lifestyle and medication) it is worth knowing that when referring to "cholesterol" there are two types (there are actually more, but for clinical treatment this simplification helps). The sum of these two types and in particular the ratio between them is what gives a true picture of your cholesterol as it affects your health.

LDL (Low Density Lipoprotein) made up mostly of lipids (fats) and is produced by your liver which means that what you eat plays a major role in how much is produced. From the liver it is pumped through the blood stream to supply energy to every cell in your body. So LDL is obviously vitally important but unused energy (i.e. excess LDL) builds up as fatty deposits in your veins and arteries and so LDL has become characterized as "bad cholesterol".

HDL (High Density Lipoprotein) is composed mostly of proteins and its function is to soak up excess LDL which it returns to the liver in order to be disposed of or reused, which is why HDL tends to be labelled "good cholesterol". However your body has rather more LDL than HDL so HDL is limited as to how much excess LDL it can clean up, though research shows that increasing the amount of exercise you take results in an increase in HDL concentrations.

The main lifestyle modifications aimed at lowering cholesterol are to cut down (or preferably cut out): smoking; drinking; inactivity; being overweight; and certain types of food. The food types to avoid are those containing saturated fat, so: butter; cheese; red meat; biscuits; cakes; pastries. Where possible, aim to substitute these foodstuffs with increased intake of fruit, vegetables, beans and oats (certain kinds of cereal for example).

If lifestyle improvements don't succeed in bringing your cholesterol levels down to acceptable levels then you should consult a medical practitioner who will investigate the possible causes of your high cholesterol and most likely prescribe one of a group of drugs called statins. The most commonly prescribed statins (from weakest to strongest and with both the clinical and brand names) are:

• Pravastatin (Lipostat)
• Simvastatin (Zocor)
• Atorvastatin (Lipitor)
• Rosuvastatin (Crestor)

In almost all cases, people who are prescribed statins tolerate them with no side-effects but it is worth bearing in mind that these drugs are able in rare circumstances to cause serious damage to muscles and the liver, especially if taken in strong doses. For this reason, if you are prescribed statins expect to have to undertake regular blood tests to monitor both the effect on cholesterol levels and also to check liver functions and symptoms of damage to muscle tissue.

To conclude then, the two medically approved and highly effective ways to lower cholesterol are 1) adopting a healthier lifestyle and 2) taking cholesterol lowering drugs under medical supervision, where the second option is most definitely an enhancement, not an alternative, to the first.