Oral systemic correlations have been a phenomenon of vital impact for decades. William Osler referred to the mouth as the “mirror” of the body and this cannot be overemphasized as many systemic conditions have orofacial manifestations that could be the first sign of the disease (Walker 1990). Cardiovascular vascular diseases are one of the noncommunicable diseases that accounts for a significant part of the reported 40 million deaths annually. Predictive biomarkers will aid in early detection and institution of management protocols that will reduce morbidity, complications and mortality. Atherogenesis is the formation of fatty plaques in the arteries and is triggered when a cell is severely injured resulting in a damaged tissue structure (Herrmann 2006). In the following stages, inflammation of the medial and internal regions can worsen due to mineral deposits where further crystallization leads to vascular calcification (Wu 2013). Co-morbidities such as diabetes mellitus (DM), hypercholesterolemia, and hypertension all pose the risk for vascular calcification which can lead to cardiovascular disease (CVD). Due to the high morbidity rates associated with CVD, it is imperative to identify CVD biomarkers as early as possible. Vascular calcifications, specifically medial arterial calcification (MAC), are detected as incidental findings (IF) on cone beam computed tomography (CBCT) scans taken for dental treatment and such findings may serve as decisive markers for underlying systemic conditions. The aim of this study is to analyze the association between hypercholesterolemia and vascular calcifications by evaluating the CBCT scans of persons with high cholesterol levels compared with matched controls whilst considering hypertension, diabetes, and periodontal status.