My husband works out an hour a day, is in the best shape of his entire life at 46, eating a very clean diet that I cook for him. He has no family history at all of heart disease, although everyone has high cholesterol in his family. The past three years, he has worked out vigorously, is very muscular, has no beef, fried foods, pork, or fast food, and eats a very high fiber diet. His BP is fine. My question is, does he really need to go on lipid-lowering medication? This appears to be his only risk factor besides being male. He has a rather high bilirubin too (1.6), so could it be some kind of liver problem causing his cholesterol to rise?