Cardiovascular diseases (CVD) are the main cause of premature death and early disability in most economically developed countries of the world and in the Russian Federation. CVD is associated just with atherosclerosis in a larger number of patients. Statins occupy one of the key places in the international clinical guidelines for the treatment and prevention of atherosclerotic CVD. However, despite the available information about the need to take statins and to achieve the target levels of total cholesterol and low-density lipoprotein cholesterol, there are practical problems in the correction of hypercholesterolemia in practical health care. The recommended target levels of cholesterol are rarely achieved and long-term adherence to prescribed statins is low. This article discusses the main differences between European (ESC/EAS) and American (ACC/AHA) guidelines for the treatment of dyslipidemia and for the decrease of blood cholesterol in order to reduce cardiovascular risk in adults, as well as the possibility of using them in Russian health care.