An elevated serum cholesterol level is one of the main risk factors for the development of atherosclerosis. In primary and secondary intervention trials it was shown that a reduction of total cholesterol in serum was accompanied by a reduction of the coronary risk: 1 percent decrease of serum cholesterol levels resulted in a reduction of coronary risk by 2 percent. Furthermore an increase of the antiatherogenic HDL cholesterol and lowering serum triglycerides cause a further decrease of the risk for the development of coronary heart disease. By controlled use of antilipidemic diets and drugs a prevention of atherosclerosis is possible resulting in an increase of life quality and expectancy.