Middle-aged adults who feel fine but have very high 'bad' cholesterol might be more likely to have hidden heart plaque, even if they don’t have symptoms.

In healthy-looking middle-aged Americans with low heart disease risk, higher 'bad' cholesterol is linked to more buildup in heart arteries — and the more cholesterol, the more common these buildups are.

If you're a middle-aged person with symptoms, having higher 'bad' cholesterol (LDL) means you're more likely to have heart problems over the next four years — but only if scans show you already have plaque in your heart arteries.

If a middle-aged person has very high 'bad' cholesterol but feels fine, they’re more than 2.6 times as likely to have early signs of heart artery buildup — even if everything else about their health is accounted for.

Even if middle-aged people have high cholesterol, nearly half of them might still have completely clean heart arteries, and over a third show no signs of plaque buildup — so high cholesterol doesn’t always mean clogged arteries.

If a middle-aged person has higher 'bad' cholesterol, they're more likely to have buildup in their heart arteries — every 38.7-point rise means about a 17% higher chance of early heart disease signs, even if they already have symptoms.