If you have high cholesterol, it doesn't always mean you need to take medication right away. High cholesterol can increase your risk of heart disease, but other factors like age, weight, smoking habits, and family history also play a role. Your doctor will evaluate your overall heart disease risk based on your medical history, physical exam, and test results. Depending on your risk level, you might be able to manage high cholesterol with lifestyle changes such as a healthy diet, regular exercise, quitting smoking, and losing weight. If these changes aren't enough, your doctor may recommend medications like statins. There are different types of high cholesterol: primary (genetic) and secondary (caused by other health conditions like diabetes or lifestyle factors). Treatment varies based on the type and severity of your high cholesterol. For primary high cholesterol, lifestyle changes and medications are often necessary. For secondary high cholesterol, lifestyle changes are usually tried first before considering medication. Your doctor may also use additional tests like a coronary calcium scan or a high-sensitivity CRP test to better understand your heart disease risk and decide if medication is needed.