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According to Framingham Heart Study, people with an age greter than 50 years have no increased overall mortality with either high or low serum cholesterol levels. There is, however, a correlation between falling cholesterol levels over the first 14 years and mortality over the following 18 years (11% overall and 14% CVD death rate increase per 1 mg/dL per year drop in cholesterol levels).

Cholesterol is an important component of the membranes of cells, providing stability. It is the major precursor for the synthesis of vitamin D, of the various steroid hormones, including cortisol, cortisone, and aldosterone in the adrenal glands, and of the sex hormones progesterone, estrogen, and testosterone. Further recent research show that cholesterol has an important role for the brain synapses as well as in the immune system.

The American Heart Association provides a set of guidelines for total (fasting) blood cholesterol levels and risk for heart disease: