Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that cholesterol target levels depends on some factors like age, cardiovascular associated rics factors like hypertension , diabetes , smoking and hereditary history of high cholesterol. In your mother in laws case cholesterol levels should be optimaly below 180 mg / dl for total cholesterol and below 70 mg / dl for ldl col. The value that you mention is pretty high and you don t mention any anti lypidic drug in the courent treatment. First of all , if I was the treating doctor, despite the courent treatment of hypertension and diabetes I would recommend a anti lipidic agent like the class of statins. Of course I would recommend the dietary changes Like avoid red meat, white bread, fast food, pizzas and sweeties. Increase vegetables, green food and regular physical activity minimaly 40 minutes every day. After these I think your mother in low will have good results in the cholesterol levels. Hope I was helpfull. Best regards,Dr.Ervina.