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Hello renee,   Your's is an interesting question; one most all adopted people I'm sure must contemplate.   High cholesterol, outside of very rare cases of astronomically high LDL, does not have signs and symptoms of its own.  By modifying the disease with medications and lifestyle changes (by that I mean lowering your LDL, and raising your HDL), the goal is to reduce the risk of heart disease.   The most important causes of heart disease can be picked up by regular visits to your doctor and modified before they cause damage to your heart.  Knowing that you have a family history of high cholesterol and heart disease makes your doctor start screening for these conditions earlier than other people.    You should tell your doctors that you are adopted because they may want to then screen you for these diseases earlier than somebody that they known doesn't have a family history of high cholesterol/heart disease.   Hope this helps.   To your health, Neil MD