The 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
This study takes a snapshot of people’s cholesterol and heart artery health at one point in time. It can show that higher cholesterol is linked to more plaque in the arteries, but it can’t prove that cholesterol caused the plaque — other factors might be involved.
Analysis score
Maximum 44 for a cross-sectional study.
Where the score came from
This study looked at heart scans of middle-aged people who feel fine but have high cholesterol to see if they have early heart disease.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 542 / 100
Quality score
Snapshots of a population at a single point in time, or descriptions of small groups. Can identify correlations and prevalence, but cannot determine cause and effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Even if your cholesterol is very high, you might not have heart damage — but some early signs can still be hiding.
- 254% of people with very high cholesterol (≥190) had no heart calcium.
- 345% had no heart plaque.
- 4But 28% of those with no calcium still had soft plaque.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Circulation
Year
2022
Authors
K. Hagan, Miguel Cainzos Achirica, Reed Mszar, S. Ali, Lara Arias, A. Saxena, R. Cury, M. Budoff, T. Feldman, S. Lahan, M. Blaha, M. Shapiro, Garima Sharma, Raul D. Santos, J. Fialkow, K. Nasir
Related Content
Claims (6)
Even if you feel fine, your arteries might start building up plaque when your 'bad' cholesterol (LDL) hits around 50 to 60 mg/dL, and the more LDL you have, the more plaque builds up — steadily and predictably.
Even if someone has very high 'bad' cholesterol, more than half of middle-aged people with no symptoms still show no signs of heart artery buildup — meaning their bodies might be naturally protecting them.
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.
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.
Even if a heart scan shows no calcium buildup, nearly 3 in 10 middle-aged people with high 'bad' cholesterol still have soft plaque in their arteries — meaning the usual heart risk test might miss early warning signs.
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.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.