For many like myself, extremely high cholesterol (300+) is familial and diet and exercise simply do not work. Since my bypass five years ago, I have been on statins (plus Zetia, plus niacin) which together with diet and exercise are probably saving my life by keeping me from clogging up again. I am grateful that I have no side effects, which have prevented some of my friends from staying on statins (although some have found that switching statins works). Incidentally, even with all of the above, LDL is still about 92, far from my cardiologist's goal of 80.