How Significant Is The Role Of Cholesterol In Heart Disease And Stroke?

Steven Nissen, M.D., Chairman, Department of Cardiovascular Medicine, Cleveland Clinic

January 2, 2009

Question: How significant is the role of cholesterol in heart disease and stroke?

Answer: Well, the question about how much is related to cholesterol is a difficult question to answer because if you don't have any cholesterol -- and there actually are a few people that are born with defects where their cholesterol levels are very low -- you just don't get coronary heart disease.

ABC News Photo Illustration

But in any given population, there is a mixture of risk factors that are driving a disease. Cholesterol is right there near the top of the list, but so is smoking and diabetes and family history. So, it's really a constellation of risk factors that operate together to cause the disease.

It's almost impossible to pull any one of those risk factors and say that in any individual patient, that's the cause. But it's a major contributor in almost everybody with the disease. About two-thirds of patients that have heart attacks have elevated cholesterol levels.

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