Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you something and give my opinion. You should know that cholesterol target levels depends on some factors like your age and other associated rics factors like hypertension, diabetes, smoking and hereditary history of high cholesterol levels. You are over 45 years old so you have entered to the rick age when we shoul take care of all factors. You dont mention other disease so the target level for you is below 180 mg / dl for total cholesterol, below 130 mg / dl for ldl col. If you say that you have a healthy diet meaning avoiding fast food,pizzas, sweeties, white bread and other high cholesterol food and if you have minimaly 40 minutes of regular physical activity than we are ok. But this also means that we cant expect to much from dietary modification and you cholesterol is still high. In this circumstances its necessary to start medical treatment. If I was your treating doctor I will recommend a statine class medication in a small dosage and repeat the blood test after 1 month to check for the right dose. In your case is essential to eliminate all risc factors so its important to lower cholesterol and also I would advise you to stop smoking. Hope I was helpfull. Best regards.