Not quite. Size matters, after all. We all know that oil and water don't mix, so how to transport fat in an aqueous medium, ie blood? Bind the cholesterol to a protein that is hydrophilic, making a lipoprotein. The resulting combination molecules can be large (HDL), small (LDL) and tiny (VLDL). The small and tiny molecules are capable of worming their way into the gaps between endothelial cells that line blood vessels, whereas the large ones are too big to fit. This is why HDL is 'good' cholesterol - it won't clog arteries. It doesn't clean your pipes out, but the more cholesterol is transported as HDL means less being moved around as LDL or VLDL. HDL also has some small effects on vessel wall inflammation, and may inhibit LDL deposition.
On to statins. Much as we learn to become cynical about drug companies, and especially the push to use them for primary prevention (ie treating people who don't have cardiovascular disease with them on the grounds that it is better to prevent than cure), aided by expert panels of docs well compensated for their time and correct opinions by drug companies, these drugs have changed the medical world. Time was when your mid-thirties were the 'heart attack years' and many men died at a young age (œstrogen encourages HDL production over LDL, but women more than catch up after menopause). Between smoking reduction preventing the heart attacks, and statins radically changing the outlook after one has occurred, far, far less premature deaths from heart disease are occurring and consequently cancer is quickly overtaking heart disease as the leading mode of death - simply meaning we have to die of something, and more people are failing to die of heart disease and thus living long enough to get cancer at some later age. There's no doubt if we gave statins to everyone, we could nearly eradicate ischæmic heart disease, peripheral vascular disease and a lot of strokes (not the untreated hypertensive ones, or the berry aneurysms). But we recoil from universal drugging, and also like to deny the manufacturers such obscene profits even if we have to die to do it. It's also true that a small minority of people can't take statins as they get rhabdomyolysis (can be fatal), abnormal liver function (probably not very harmful) and muscle pains (annoying but not dangerous as long as no rhabdomyolysis occurs) - hence the need for regular CPK and LFT testing to identify such patients. We already routinely put diabetics onto statins even if they have no vascular disease, as their risk is high enough that this is justified. Statins primarily lower LDL, and sometimes raise HDL, sometimes not. Getting your LDL as low as possible not only halts deposition of crud in artery walls, it can reverse it, which is remarkable. They can clean your pipes.
In all of this, we have not addressed triglycerides, which are another form of fat in the bloodstream. Type IV hyperlipidæmia is purely a hypertriglyceridæmia, and kills quickly in its serious inherited form. Remember elevated triglycerides are one of the three legs of the 'metabolic syndrome' and thus a problem for nearly all type 2 diabetics. Drug treatments to lower them are not very effective, with statins, fibrates and niacin used, but not as effective as weight loss, exercise and glycæmic control.
Here endeth the lesson, and sorry for the diphthongs. I did learn the simplified norte americano
spelling, but am developing curmudgeonly tendencies in my old age.