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Letty,   Thanks for your question.  Assuming your efforts with diet and exercise were maximal, a year is a good trial to see how effective these efforts have been, and you still have a way to go.  If you have not given diet and exercise your 100% effort, then give it another six months.  Review our website for tips and information on diet and lifestyle changes that may be helpful in getting your numbers down and keeping them there.  Cut out all fast foods, processed foods, and concentrate on more fish, chicken breast without the skin, fresh fruits, vegetables, and nuts.    If you have devoted 100% effort, then it is time to take medication to get your numbers down.  Does this mean you will take drugs for life?  Not necessarily, as some patients, with continued diligence in diet, exercise, and weight loss (if necessary) can continue to achieve good results leading some doctors to stop medication and see how patients do on their own (as a trial).   Remember that diet, exercise and lifestyle are one factor.  Another important factor is genetics which is a major case of elevated cholesterol.  If this is the case, then medication may be the best answer.   Best wishes.   Martin Cane, M.D.