My total/LDL numbers two years ago were 260/170, very close to yours. They'd been around the same range but rising slightly for many years. My doctor gave me one last chance last year to employ diet and exercise. I was already near an ideal weight and exercised 45 minutes per day, but I cut out red meat entirely for a year. It only lowered to 258/165 and on the statins I went. I finally got my lab results back and am down to 153/70.
As I understand it, high cholesterol can be hereditary and not all forms of it will respond to diet and exercise. So, I'm unlucky in that regard, but appear to be lucky in terms of being able to control it with medication without any adverse reactions.
I'm frightened of medications after a few bad experiences but no longer research side-effects ahead of time. I'll just end up doom-scrolling and psyching myself out. So, I just take the plunge. If something starts going wrong, I'll do some research and contact my doctor then. There are good medications available that work. Different doses are prescribed and I'm actually on a low dose.