Good morning, First of all, a cholesterol level of 200 is normal. We advise the population to keep it below 200,optimally around 180 mg/dl. So, it was not your cholesterol as much that prompted the doctor to put you on fenofibrate as it was your triglycerides although I will point out that while your cholesterol seems not to be an issue, the fact that you are a smoker makes it an issue. You have a higher risk for heart disease as a smoker with a cholesterol of 200 than a non-smoker with a cholesterol of 200 mg/dl. Fenofibrate is used to lower triglyceride levels and yours was high at 219 when our goal for heart health is below 150 mg/dl. And, no, you would not have to take them for lifetime if you make some positive dietary and exercise lifestyle changes. Quitting smoking is first priority. Next, for triglycerides, lower the alcohol in diet, all sugars, limit starchy food and switch from saturated fats to polyunsaturated and monounsaturated fats. No frying. For example, use canola oil, extra virgin olive oil, healthy margarine blends. Gradually increase fiber to 25 gm per day by emphasizing water soluble fibers such as oats (Oatmeal, Oat dry cereal, oat bread, legumes). Triglycerides are sensitive to fructose, so cut out the juice, read labels for high fructose corn syrup and avoid. Eat fresh fruit instead. Salads, fresh vegetables, sauteed vegies and rice, low fat dairy, whole grains. . .all will help lower those blood fats so you can control you health without some of the medication. Regards, Kathy Shattler, MS,RDN