Subclinical atherosclerosis develops in a linear relationship with LDL cholesterol levels, with plaque accumulation beginning at LDL concentrations of approximately 50–60 mg/dL, even in individuals without symptoms.

Study: Normal LDL-Cholesterol Levels Are Associated With Subclinical Atherosclerosis in the Absence of Risk Factors.

The study found that even people with normal cholesterol levels can have early signs of artery plaque, and higher LDL cholesterol was linked to more plaque — which supports the idea that plaque starts building up at relatively low cholesterol levels.

Study: Normal LDL-Cholesterol Levels Are Associated With Subclinical Atherosclerosis in the Absence of Risk Factors.

The study found that even people with normal cholesterol levels can have early signs of artery plaque, and higher LDL cholesterol increases that risk — which supports the idea that plaque can start building up at relatively low cholesterol levels.

Study: Non-HDL and LDL cholesterol, but not calculated remnant cholesterol, are associated with subclinical atherosclerosis.

The study shows that higher 'bad' cholesterol (LDL) is linked to early signs of artery damage, even in healthy people, which supports the idea that plaque can start building up at relatively low cholesterol levels.

Study: Abstract 13515: LDL-Cholesterol, Coronary Plaque, and Resilience to Coronary Atherosclerosis in a Middle-Aged Asymptomatic US Population: The Miami Heart Study at Baptist Health South Florida

The study found that many people with very high cholesterol had no heart plaque, which means plaque doesn’t always build up in a straight line as cholesterol rises, especially at lower levels.