High cholesterol will lead to blockage on your arteries. Once your arteries become more than 60 percent blocked you now have a situation where your heart is working harder to pump the blood. After a while that 60 percent becomes 80 or 90 percent and your in deep shit. Now you have a chance for real heart problems or the need for a bypass to clean them out.
It's not the high numbers but what the numbers represent. If you can have high numbers without any artery blockage your doing well. Unfortunately that doesn't happen.