Cholesterol is related to but not the direct cause of arteriosclerosis, heart disease, or strokes. We cannot live without cholesterol; we must have it to make cell membranes, vitamin D, many hormones, many neurotransmitters, and bile salts. Yet it is related to heart disease.
In general, the higher the cholesterol the worse the risk for heart disease. But it is not the total that is most important, it is the relationship between types of cholesterol subfractions. There are nine different types of LDL cholesterol and five different types of HDL that provide even further specific information. In general, it is the ratio of HDL to total cholesterol that should be used in general screens. Lowering LDL has value to a certain point, but beyond a certain point low cholesterol may reduce heart disease but increase all cause mortality. Vytorin, a combination of Zocor and Zetia, is used by many MDs to lower cholesterol more than other known drug treatments, may lower the risk of dying from a heart attack, but all cause mortality may be higher and overall wellness is compromised by a cholesterol deficiency.