Table of ContentsView AllTable of ContentsWhat It Tells YouHow It’s CalculatedNon-HDL vs. CholesterolNormal Ratio RangesHigh Ratio RisksImproving CholesterolFactors Affecting Ratio
Table of ContentsView All
View All
Table of Contents
What It Tells You
How It’s Calculated
Non-HDL vs. Cholesterol
Normal Ratio Ranges
High Ratio Risks
Improving Cholesterol
Factors Affecting Ratio
The normal amounts of HDL are between 35 and 65 milligrams per deciliter (mg/dL) in adult males, and 35 to 80 mg/dL in females. When your overall cholesterol is over 200 mg/dL, you may be at higher risk of heart disease. If your chol/HDL level is high, your healthcare provider may want to discuss lifestyle changes or medication to better control your cholesterol levels.
This article looks at how a cholesterol ratio is calculated and what it means for your health. It also discusses ways to improve cholesterol levels.
What Is a Cholesterol Ratio?
Your cholesterol ratio is a comparison of how much HDL you have in your body compared to your total cholesterol level. Total cholesterol is a measure of all cholesterol in your blood, including the main types:
While important, total cholesterol doesn’t reveal as much about your cardiovascular risk as knowing why your level is what it is.
Your total cholesterol could be high because LDL is more prevalent than HDL, which is harmful. But it could also be high because you have a lot of beneficial HDL. Therefore, your cholesterol ratio provides more information about your risk than just your total cholesterol number.
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How Your Chol/HDL Ratio Is Calculated
Before calculating your cholesterol ratio, your healthcare provider will need to order alipid panel test. These blood tests help determine how much of each type of cholesterol you have in your bloodstream. They also reveal your level oftriglycerides, a stored type of fat that can also increase heart disease risk.
For example, if your total cholesterol is 180 and your HDL is 60, your cholesterol ratio is 3 to 1.
The higher the ratio, the higher the risk.
What Is Considered a Good HDL Cholesterol Level?The normal amounts of “good HDL cholesterol” are between 35 and 65 mg/dL in adult males and 35 to 80 mg/dL in females.
What Is Considered a Good HDL Cholesterol Level?
The normal amounts of “good HDL cholesterol” are between 35 and 65 mg/dL in adult males and 35 to 80 mg/dL in females.
Non-HDL Cholesterol vs. Cholesterol Ratio
Non-HDL cholesterolis another way healthcare providers try to determine your risk of heart disease. It includes LDL cholesterol and other types of cholesterol such as very-low-density lipoprotein (VLDL), which plays a role in cholesterol build-up in the arteries.
To obtain this number, your HDL cholesterol is subtracted from your total cholesterol.
A normal level of non-HDL cholesterol for adults is less than 130 mg/dL.The higher the number, the higher your risk of heart disease.
Both non-HDL cholesterol and cholesterol-to-HDL ratio appear to be better heart disease risk predictors than total cholesterol or LDL cholesterol levels alone.
Some healthcare providers prefer non-HDL cholesterol, however. This is because non-HDL has a more linear relationship with your risk of heart disease. For example, as your non-HDL number goes up, your risk for heart disease goes up proportionally. This makes the number easier to interpret.
Very Low Density Lipoprotein (VLDL)
What Is a Normal Chol/HDL Ratio?
Your cholesterol ratio can determine if you are at risk for heart disease and if so, how high your risk is.
A high ratio is usually due to high LDL and/or VLDL cholesterol, orlow HDL cholesterol. A combination of factors play into this, such as eating a lot of saturated fat, not getting enough exercise, age, and more.
Why Is Your Chol/HDL Ratio Important?
Too much LDL cholesterol in your blood can cause a type of heart disease calledatherosclerosis.
This is a condition in which the flow of blood to the heart muscle is slowed. It can even stop blood from getting to the heart altogether, increasing your risk of aheart attackor stroke.
A 2019 study that looked at heart attack risk in women found that even people with “normal” ratios had an elevated risk of heart disease:
When your cholesterol is too high, you are at greater risk for having a heart attack or a stroke. High cholesterol can also contribute to other health problems like peripheral artery disease and high blood pressure.
How to Improve Your Cholesterol
If your cholesterol ratio comes back too high, there are things you can do to help improve your numbers. This includes lifestyle changes and medication.
Lifestyle Changes
If you want to improve your cholesterol levels, one of the best things you can do is to make lifestyle changes, such as with your diet and exercise.
Below are lifestyle habits you can change to help get cholesterol levels within normal ranges:
Medication
If lifestyle changes alone are not enough to lower your cholesterol, you may also need to take cholesterol medication.Statinsare the most common class of medications used to lower cholesterol.However, several different types of cholesterol-lowering medicines are available.
Thevarious medicationswork to lower cholesterol in different ways and can have different side effects. Do not stop taking your cholesterol medication if you feel a medication is not right for you. Always consult with your healthcare professional about stopping, changing, and/or finding the right medication for you.
In addition, don’t stop working to improve your lifestyle habits just because you are on cholesterol medicine. Cholesterol-lowering medications work best as you continue to implement heart-healthy lifestyle changes.
Drug Nexletol Lowers Cholesterol Without the Side Effects of Statins
What Can Affect Your Chol/HDL Ratio?
A number of factors can affect your cholesterol levels, tests and, therefore, the ratio values between your total cholesterol and HDL. These factors include:
Keep in mind that your age, gender, and any underlying medical conditions also affect test results.
Summary
Cholesterol ratio may be one of the tests reported when your healthcare professional checks your risk for heart disease. It is calculated from total cholesterol and HDL cholesterol. A lower number indicates lower risk, with the optimal level being between 3.5 to 1.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.University of California San Diego Health.Lipid Panel with Total Cholesterol: HDL Ratio.American Heart Association.HDL (Good), LDL (Bad) Cholesterol and Triglycerides.MedlinePlus.Cholesterol levels: What you need to know.Calling S, Johansson SE, Wolff M, et al.Total cholesterol/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease: a 17-year follow-up study of women in southern Sweden.BMC Cardiovasc Disord.2021;21(1):1-9. doi:10.1186/s12872-021-01971-1American Heart Association.American Heart Association recommendations for physical activity in adults and kids.Calling S, Johansson SE, Wolff M, et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord.2019;19(1):1-9. doi:10.1186/s12872-019-1228-7American Heart Association.The American Heart Association Diet and Lifestyle Recommendations.National Heart, Lung, and Blood Institute.Blood cholesterol.National Heart, Lung, and Blood Institute.Smoking and your heart.Sadowska A, Osiński P, Roztocka A, Kaczmarz-Chojnacka K, Zapora E, Sawicka D, Car H.Statins-From Fungi to Pharmacy.Int J Mol Sci. 2023 Dec 29;25(1):466. doi:10.3390/ijms25010466.University of Rochester Medical Center.Lipid Panel with Total Cholesterol: HDL Ratio.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.University of California San Diego Health.Lipid Panel with Total Cholesterol: HDL Ratio.American Heart Association.HDL (Good), LDL (Bad) Cholesterol and Triglycerides.MedlinePlus.Cholesterol levels: What you need to know.Calling S, Johansson SE, Wolff M, et al.Total cholesterol/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease: a 17-year follow-up study of women in southern Sweden.BMC Cardiovasc Disord.2021;21(1):1-9. doi:10.1186/s12872-021-01971-1American Heart Association.American Heart Association recommendations for physical activity in adults and kids.Calling S, Johansson SE, Wolff M, et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord.2019;19(1):1-9. doi:10.1186/s12872-019-1228-7American Heart Association.The American Heart Association Diet and Lifestyle Recommendations.National Heart, Lung, and Blood Institute.Blood cholesterol.National Heart, Lung, and Blood Institute.Smoking and your heart.Sadowska A, Osiński P, Roztocka A, Kaczmarz-Chojnacka K, Zapora E, Sawicka D, Car H.Statins-From Fungi to Pharmacy.Int J Mol Sci. 2023 Dec 29;25(1):466. doi:10.3390/ijms25010466.University of Rochester Medical Center.Lipid Panel with Total Cholesterol: HDL Ratio.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
University of California San Diego Health.Lipid Panel with Total Cholesterol: HDL Ratio.American Heart Association.HDL (Good), LDL (Bad) Cholesterol and Triglycerides.MedlinePlus.Cholesterol levels: What you need to know.Calling S, Johansson SE, Wolff M, et al.Total cholesterol/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease: a 17-year follow-up study of women in southern Sweden.BMC Cardiovasc Disord.2021;21(1):1-9. doi:10.1186/s12872-021-01971-1American Heart Association.American Heart Association recommendations for physical activity in adults and kids.Calling S, Johansson SE, Wolff M, et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord.2019;19(1):1-9. doi:10.1186/s12872-019-1228-7American Heart Association.The American Heart Association Diet and Lifestyle Recommendations.National Heart, Lung, and Blood Institute.Blood cholesterol.National Heart, Lung, and Blood Institute.Smoking and your heart.Sadowska A, Osiński P, Roztocka A, Kaczmarz-Chojnacka K, Zapora E, Sawicka D, Car H.Statins-From Fungi to Pharmacy.Int J Mol Sci. 2023 Dec 29;25(1):466. doi:10.3390/ijms25010466.University of Rochester Medical Center.Lipid Panel with Total Cholesterol: HDL Ratio.
University of California San Diego Health.Lipid Panel with Total Cholesterol: HDL Ratio.
American Heart Association.HDL (Good), LDL (Bad) Cholesterol and Triglycerides.
MedlinePlus.Cholesterol levels: What you need to know.
Calling S, Johansson SE, Wolff M, et al.Total cholesterol/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease: a 17-year follow-up study of women in southern Sweden.BMC Cardiovasc Disord.2021;21(1):1-9. doi:10.1186/s12872-021-01971-1
American Heart Association.American Heart Association recommendations for physical activity in adults and kids.
Calling S, Johansson SE, Wolff M, et al.The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in women’s health in the Lund area (WHILA): a 17-year follow-up cohort study.BMC Cardiovasc Disord.2019;19(1):1-9. doi:10.1186/s12872-019-1228-7
American Heart Association.The American Heart Association Diet and Lifestyle Recommendations.
National Heart, Lung, and Blood Institute.Blood cholesterol.
National Heart, Lung, and Blood Institute.Smoking and your heart.
Sadowska A, Osiński P, Roztocka A, Kaczmarz-Chojnacka K, Zapora E, Sawicka D, Car H.Statins-From Fungi to Pharmacy.Int J Mol Sci. 2023 Dec 29;25(1):466. doi:10.3390/ijms25010466.
University of Rochester Medical Center.Lipid Panel with Total Cholesterol: HDL Ratio.
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