How important are non-HDL cholesterol and cholesterol ratio?

Answer From Francisco Lopez-Jimenez, M.D.

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.


Francisco Lopez-Jimenez, M.D.

Jan. 12, 2024