Bad cholesterol threatens people in their 20s, experts warn

MEDICENTER TV / ISTANBUL, TURKEY — DECEMBER 24, 2025

High levels of bad cholesterol, known as LDL, can silently accumulate in arteries for years, significantly increasing the risk of heart attack and stroke, according to medical experts.

Cardiovascular diseases remain one of the leading causes of death worldwide and in Türkiye. Physicians warn that high LDL cholesterol is no longer only a concern for older adults but has become a growing health threat for people in their 20s.

When present in excessive amounts in the blood, LDL cholesterol can form hardened deposits called atherosclerotic plaques. These plaques cause a condition commonly known as atherosclerosis, or hardening of the arteries, which can severely damage the cardiovascular system and lead to life-threatening events such as heart attacks and strokes. Sedentary lifestyles and rising obesity rates among young adults further increase the risk.

Bad cholesterol increases heart attack and stroke risk

Dr. Ozan Kocakaya, MD, Internal Medicine Specialist at Acıbadem Fulya Hospital, explains that cholesterol is divided into two main types: good cholesterol (HDL) and bad cholesterol (LDL).

Kocakaya notes that HDL is the only cholesterol value that should be high, ideally above 50–55 mg/dL. In contrast, elevated LDL cholesterol can accumulate on artery walls and cause coronary artery disease, peripheral arterial disease affecting blood flow to the arms and legs, and carotid artery disease that disrupts blood flow to the brain.

“These conditions can ultimately result in heart attacks or strokes,” Kocakaya said, emphasizing that LDL cholesterol levels should remain below 130 mg/dL and should never be allowed to exceed 190 mg/dL.

Silent progression makes early screening critical

One of the most dangerous aspects of high LDL cholesterol is that it often causes no symptoms while gradually damaging blood vessels. For this reason, regular cholesterol screening plays a crucial role in prevention.

Dr. Kocakaya stressed that everyone should have their cholesterol levels checked regularly starting at age 20, even if they feel completely healthy. Early detection, he said, can significantly reduce the risk of heart attacks and strokes.

How often should cholesterol be checked?

According to medical guidelines, cholesterol screening frequency varies by age and sex. For men, testing is recommended every five years between ages 20 and 44, every one to two years between ages 45 and 60, and annually after age 65.

For women, cholesterol checks every five years are generally sufficient until menopause. After menopause, when estrogen’s protective effect on blood vessels declines, annual testing is advised.

Additional risk factors such as a family history of heart disease or stroke, diabetes, obesity, or smoking may require more frequent monitoring under a physician’s supervision.

Diet and exercise are key to treatment

While cholesterol numbers provide valuable information, doctors emphasize that they represent only part of an individual’s overall cardiovascular risk profile. Lifestyle habits remain the foundation of both prevention and treatment.

Dr. Kocakaya stated that reducing unhealthy dietary habits and increasing physical activity can significantly lower LDL cholesterol levels. When necessary, medications may also be prescribed to reduce cholesterol production in the liver.

“These medications are highly effective,” he said, adding that when compared with the serious risks posed by cardiovascular diseases, cholesterol-lowering drugs are considered very safe.

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