Strict adherence to the Therapeutic Lifestyles Changes (TLC) diet designed by the National Heart, Lung, and Blood Institute of the National Institutes of Health can reduce LDL cholesterol 30%, equal to that offered by medication.
For people who are unable to control cholesterol with diet or have other risk factors for heart disease – such as cigarette smoking, high blood pressure, the need for blood pressure medication, or a family history of heart disease – medications might be necessary.
The most popular cholesterol-lowering drug class called statins work by stopping a key enzyme involved in the making cholesterol. (Some studies show that the supplement red yeast rice (Monascus purpureus) may work similarly to lower cholesterol.) Other drugs work to decrease absorption, breakdown or elimination of cholesterol in the body. Some lipid-lowering agents are combined with other medicines for heart disease.