Cholesterol ratio or non-HDL cholesterol: Which is most important?

    How important are non-HDL cholesterol and cholesterol ratio?

    For predicting your risk of heart disease, many healthcare professionals now believe that determining your non-HDL cholesterol level may be more useful than calculating your cholesterol ratio. And either of those two options seems to be a better risk predictor than your total cholesterol level or your low-density lipoprotein (LDL) cholesterol level, known as the "bad" cholesterol.

    As the name implies, the non-HDL cholesterol level simply subtracts your high-density lipoprotein (HDL) cholesterol, known as the "good" cholesterol, number from your total cholesterol number. So the non-HDL number includes all the bad types of cholesterol.

    An optimal level of non-HDL cholesterol for most people is less than 130 milligrams per deciliter (mg/dL), which is 3.37 millimoles per liter (mmol/L). For people with a history of heart attack, the desired level may be lower. Higher numbers mean a higher risk of heart disease.

    To calculate your cholesterol ratio, divide your total cholesterol number by your HDL cholesterol number. So if your total cholesterol is 200 mg/dL (5.2 mmol/L) and your HDL is 50 mg/dL (1.3 mmol/L), your ratio would be 4-to-1. Higher ratios mean a higher risk of heart disease.

    1. Sandeep V. Screening for lipid disorders. https://www.uptodate.com/contents/search. Accessed Aug. 28, 2023.
    2. Rosenson RS. Measurement of blood lipids and lipoproteins. https://www.uptodate.com/contents/search. Accessed Aug. 28, 2023.
    3. Non-high density lipoprotein cholesterol. Lab Tests Online. American Association for Clinical Chemistry. https://labtestsonline.org/tests/non-high-density-lipoprotein-cholesterol. Accessed Aug. 28, 2023.
    4. Heart smart basics: What to know to keep yours healthy fact sheet. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/resources/heartsmart-basics-what-know-keep-yours-healthy-fact-sheet. Accessed Sept. 25, 2023.

    FAQ-20058006


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