The therapeutic aim in patients with LDL-hypercholesterolemia and coronary heart disease is to reduce LDL-cholesterol levels to around 100 mg/dl. Since such levels are hardly ever reached solely by diet modifications, inevitably the targeted use of cholesterol-lowering drugs is required. Drug therapy of LDL-hypercholesterolemia nowadays includes the following: anion exchange resins, HMG CoA-reductase-inhibitors, fibrates, nicotinic acid and its derivatives, beta-sitosterol and probucol. If cholesterol levels are not sufficiently lowered in response to monotherapy with one of these drugs combined drug therapy should be attempted. Should this likewise prove unsatisfactory then LDL apheresis can be attempted at regular intervals. This regimen usually achieves the desired LDL-cholesterol level even in severe cases.