High cholesterol is more common in males assigned at birth compared to females assigned at birth under age 55, while females assigned at birth are more likely to develop high cholesterol when they are over 55. The risk of developing high cholesterol increases with age. People who smoke, have diabetes, are overweight, or follow a poor diet are at increased risk. If you have a first degree relative with high cholesterol and heart disease at a young age, you are more likely to develop high cholesterol and heart disease.