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It was not until the twentieth century that cholesterol was identified as a key component of atherosclerosis.  It was not till 1930’s, the genetic link between high cholesterol and myocardial infarction (heart attack) was identified.
Based on gathered evidence, decreasing blood cholesterol levels for those at risk should be a national public health goal.  Criteria for treatment has been changing.  Latest one as per 2013 Guideline ACC/AHA – Guideline on treatment of blood cholesterol, to reduce Atherosclerosis Cardiovascular Risk in Adults. (cardiosource.org; my.americanheart.org)
Treatment of cholesterol disorders is medication + Therapeutic lifestyle.  Statin therapy can decrease bad cholesterol by 50% more or less.
Therapeutic lifestyle can decrease bad cholesterol (LDL-C) by about 15-30%.  Patients with diabetes are at high risk.