The need for medication to manage cholesterol levels depends on various factors, including overall cardiovascular risk, individual health conditions, and response to lifestyle changes. A cholesterol level of 240 mg/dL is generally considered high, but treatment decisions should be made in consultation with a healthcare professional. They will assess your complete lipid profile, evaluate other risk factors, and determine whether lifestyle modifications alone or a combination of lifestyle changes and medication are necessary to achieve target cholesterol levels and reduce the risk of cardiovascular diseases.