Conflicting data exist on the need for cholesterol drug therapy. Consensus recommendations now call for nearly every smoker over 35 years old and every man over 60 years old to be on them. If you have high blood pressure and are over 50 with high cholesterol, your doctor is supposed to put you on a statin drug. The side effects in the popular press of statin seem exaggerated, with data actually showing more protection from cognitive impairment and dementia from taking the drugs than side effects of a similar sort.
This is an ever-evolving field, yet as of today, the data would suggest that the anti-inflammatory effect of statins far exceeds the lipid-lowering effect by protecting you from heart disease, stroke, and dementia or cognitive impairment. Still, blood pressure control, smoking cessation, and weight loss are the mainstays to prevent all of these if you do want to go on a statin drug. Also, the non statin cholesterol drugs, like niacin, niaspan, and zetia, have been shown now to be of no value for cardiac and vascular disease protection. Same with fish oil supplements. So if you take these you can drop them. Statins seem to be the only thing, over the counter or prescription, that effectively treats the cardiovascular complications of high cholesterol.