The goal of high cholesterol treatment is to lower your cholesterol enough to reduce your risk of heart disease or a heart attack. To lower cholesterol, it's usually best to begin with lifestyle changes such as losing weight, changing your diet, and getting exercise. Quitting smoking or nicotine use can also help lower cholesterol because nicotine can make blood vessels narrow and lower your HDL ("good" cholesterol). If lifestyle changes alone do not lower your cholesterol enough, medications -- such as fibrates, statins, bile acid sequestrants, and cholesterol absorption inhibitors -- may be necessary. While it can take decades for high cholesterol to have a negative effect on your health, it's important to remember that high cholesterol does cause damage even when you don't have any noticeable symptoms.