Cholesterol and heart disease

When referring to cholesterol, be it LDL or HDL, we're actually not talking about the cholesterol itself.

LDL stands for Low Density Lipoprotein and HDL for High Density Lipoprotein.

The lipoproteins are proteins that carry fat, cholesterol, phospholipids and fat soluble vitamins around in the bloodstream.

The thing with cholesterol (or more accurately, the lipoproteins that carry around the cholesterol) is that elevated blood levels of it are associated with an increased risk of heart disease.

This does not necessarily mean that high cholesterol causes heart disease, just that people who have a lot of cholesterol are more likely to get it (2, 3).

This graph from the massive MRFIT study (4) clearly shows that in men, total cholesterol above 240 mg/dL (6.2 mmol/L) is associated with an increased risk of death, specifically from heart disease.

Photo source.

However, it's important to note that cholesterol that is too low is also associated with an increased risk of death, but not from heart disease (5, 6, 7).

The relationship between total cholesterol and cardiovascular disease is complex. For example, in very old individuals, more cholesterol appears to be protective (8, 9).

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