A major study by the World Health Organization shows that most people with high cholesterol levels around the world are not getting the treatment they need, to avoid such serious diseases as heart attacks and strokes. And the authors of the study - the largest ever undertaken - say the problem is especially serious in the developing world.
The connection between high cholesterol and heart attacks is not new. But the new global study serves as yet another warning about the growing epidemic of untreated high cholesterol levels, which can cause cardiovascular disease.
The study was done on 147 million people - and found an increasing incidence of high levels of cholesterol the world over. Even more worrying, the researchers say, is that many of those patients are going untreated.
In Japan, for example, 53 per cent of those diagnosed with high cholesterol did not get treatment. While in Thailand, 78 per cent of those surveyed were never even diagnosed.
Experts are stressing the basics yet again. Dr Chelsea Kidwell, Director of the Georgetown Stroke Center in Washington, said "As developing countries adopt a western diet - the cholesterol levels are increasing so people need to understand that high cholesterol is a significant risk factor for stroke and heart disease."
A high level of so-called "bad" cholesterol causes plaque in the bloodstream, which can slow down the blood flow to the heart. If not enough blood and oxygen reach the heart, it can result in a heart attack. If the blockage keeps blood from getting to the brain, it can cause a stroke. On its own, high cholesterol does not cause any symptoms so many times people are unaware of the problem until a stroke or heart attack hits.
"A simple blood test can tell you where your cholesterol levels are and we have target ranges that we know decreases the risk of stroke and heart attack for example the bad type of cholesterol we would like to keep it under 100 and that minimizes the risk of having an event," said Dr. Kidwell.
Cardiovascular disease kills more than 17 million people every year and WHO says 80 percent of these deaths occur in developing countries.
Dr Joseph Sabik of Cleveland Clinic says the risk can be reduced by making simple lifestyle changes.
"If you’re someone that’s overweight - you gotta lose weight. If you’re sedentary, you have to exercise. If you have a strong family history and the genetics are there. You have to (take aggressive action) to take care of yourself," he said.
Lifestyle changes may not benefit everyone. Medication may become necessary for those whose cholesterol levels are very high.
But Dr. Kidwell says medication may be out of reach for many people. "Globally they are probably not going to be affordable in some of the developing countries and that is an ongoing problem that the health care community needs to address," she said.
Global health experts say that along with improved screening and treatment for cholesterol people should eat less salt and fewer saturated fats, and avoid tobacco. They believe these steps can help stem the rising tide of global cholesterol levels.