Cholesterol should be measured as early as the age of 25 to enable young people to mitigate against the risk of cardiovascular events, scientists say.
Interventions could include taking statins, or adopting a healthy lifestyle.
A comprehensive analysis suggests a strong link between non-HDL cholesterol - bad cholesterol - levels and long-term risk for cardiovascular disease (CVD) in people aged under 45.
Researchers suggest halving levels of bad cholesterol could decrease cardiovascular risks four-fold.
Depending on cholesterol level and the number of cardiovascular risk factors, men and women aged under 45 have a 12-43 per cent or 6-24 per cent risk, respectively, of having fatal or non-fatal heart disease or stroke by the age of 75.
The observational and modelling study used data from 398,846 people.
The study published in the Lancet sets out that women with bad cholesterol levels between 3.7-4.8 mmol/litre, who were younger than 45, and had at least two additional cardiovascular risk factors, had a 16 per cent probability of experiencing a cardiovascular disease event by the age of 75.
For women aged 60 or over with the same characteristics, the estimated risk was 12 per cent.
The study found that for men with the same characteristics, the estimated risk for those aged under 45 was 29 per cent, and was 21 per cent for those aged 60 or more.
Co-author Professor Stefan Blankenberg, medical and clinical director at the University Heart and Vascular Center UKE Hamburg, said: “There’s one key message - you should at least put into the guidelines that LDL and non-HDL cholesterol determination should be an obligation. You should determine your cholesterol at the very young age. You need to enable these younger individuals to do something against the risk.
“The second message is that you need to show these young people their potential risk.”
He added that cholesterol could be measured at the age of 25 or 30, potentially providing an opportunity to consider taking statins.
Researchers said that even those who were young and lived a healthy lifestyle could benefit from their hypothesis if they had a genetic risk.
Professor Frank Kee, of Queens University Belfast, added: “The more health literate might be able to deal with this better than people who are living in disadvantage.
“So, any strategy to reduce the risk must not widen inequalities.”