Epidemiological and clinical studies have clearly established the link between elevated low-density lipoprotein cholesterol (LDL-C) and coronary heart disease (CHD). Consequently, treatment guidelines have been developed that identify LDL-C as a causative factor for CHD and as a target for lipid-lowering therapy. The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are considered the drugs of choice for lowering LDL-C in patients with hypercholesterolaemia. However, despite the proven efficacy of statins in reducing LDL-C, many patients do not achieve recommended LDL-C target levels. Surveys suggest that patients do not receive the appropriate drugs in adequate dosage to reach LDL-C target values. Success in achieving targets is lowest in patients at the highest risk, i.e. those with established CHD. The introduction of more potent HMG-CoA reductase inhibitors, or the use of higher doses of older statins, should allow more patients to achieve LDL-C target levels.