High levels of cholesterol can first lead directly to
a. strokes
b. arteriosclerosis
c. heart attacks
d. heart failure

I think it's b I'm not quite sure though I hope I helped you 

In order to help the student expand his/her knowledge I will help answer the question. This in hope that the student will get a piece of knowledge that will help him/her through his/her homework or future tests.  

High levels of cholesterol can first lead directly to arteriosclerosis which is the thickening and hardening of the wall arteries. The correct choice is letter  

b. arteriosclerosis    

I hope it helps, Regards.