A study published in JAMA Cardiology found that many adults with dangerously high cholesterol levels aren’t aware of it, putting them at risk for heart attack, stroke and death, according to Health.com.

About 1 in 16 adults in the United States have moderately high low-density lipoprotein (LDL) cholesterol, or “bad cholesterol,” levels (160–189 milligrams/deciliter) and 1 in 48 adults have very high LDL cholesterol levels (190 mg/dL or greater).

The study compared data from 23,667 participants between 1999 and 2020. Authors found that LDL cholesterol levels decreased over the period. In fact, the proportion of people with moderately high LDL cholesterol decreased from 12.4% to 6.1% and the proportion of with very high levels dropped from 3.8% to 2.1%.

About 27% of people with very high LDL cholesterol and about 43% of people with moderately high LDL cholesterol were unaware of their condition and not receiving treatment for it, according to the study.

Black, Latino and socioeconomically disadvantaged constitute a disproportionate number of  those unaware of their elevated LDL cholesterol, the study reports. Young people were also more affected.

Cardiovascular disease is the leading cause of death in women in the United States, according to the Centers for Disease Control and Prevention. One in five female deaths are attributed to heart disease, yet only about half of women are aware of the risk. Even fewer Black and Latina women are aware that they are at risk.

Similarly, only one in three Latina women are aware of the risks associated with heart disease, according to the American Heart Association. Latinos are also more susceptible to the condition because of their tendency to have high rates of certain risk factors, including diabetes, high cholesterol and high blood pressure.

Reduced access to primary care physicians, low rates of screening and lack of health insurance all factor into this lack of awareness. Study authors also acknowledge that inconsistent screening recommendations and an “insufficient emphasis on LDL [cholesterol] as a quality measure” also hamper awareness.

The study authors emphasize the importance of knowing your cholesterol levels and  triglyceride levels.

Statins are among the most prescribed drugs in the United States to help lower cholesterol. The medications help millions of people manage and lower their total cholesterol and reduce their risk for heart attack or stroke, according to the Mayo Clinic.

To learn more about heart health, click #Cholesterol or visit Real Health Basics on Heart Disease for more information.