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Illustration of high levels of cholesterol (yellow balls) in a blood vessel. Cholesterol is a lipid, a fat-like substance. High blood levels of LDL (low-density lipoprotein) cholesterol compared to HDL (high-density lipoprotein) cholesterol are thought to raise the risk of atherosclerosis, the build-up of fatty deposits on artery walls. This is a major cause of heart attack and stroke.