Cholesterol/HDL ratio blood test
Total cholesterol to HDL cholesterol ratio
In short
A typical adult Cholesterol/HDL ratio result is under 5 ratio (desirable). A higher ratio points to higher heart risk, from high total cholesterol, low HDL or both. What it means for you depends on your overall heart risk. Always read your result against the range printed on your own report.
Total cholesterol divided by HDL; lower is better.
This ratio divides your total cholesterol by your HDL, the 'good' cholesterol. A lower ratio means more of your cholesterol is the protective kind. Most doctors want it under 5, and under 3.5 is considered very good.
Is my Cholesterol/HDL ratio high or low?
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Typical range
| For | Range | Unit |
|---|---|---|
| Adults · desirable | under 5 | ratio |
Typical ranges for adults. Labs differ a little, so the range printed next to your result is the one to go by.
If your Cholesterol/HDL ratio is high
A higher ratio points to higher heart risk, from high total cholesterol, low HDL or both. What it means for you depends on your overall heart risk.
Common reasons
- Low HDL, often with little activity, extra weight or smoking
- High LDL or high triglycerides
- High blood sugar or type 2 diabetes
- Genes: cholesterol levels often run in families
- Less often: an inherited condition that causes very high cholesterol
Questions to take to your appointment
- 1Is my ratio high because of low HDL or high total cholesterol?
- 2What target fits my overall heart risk?
Read together with
Doctors rarely read Cholesterol/HDL ratio alone. These usually sit next to it.
- Total cholesterolAll the cholesterol in your blood, good and bad together.
- HDL cholesterolThe 'good' cholesterol that carries extra cholesterol back to the liver.
- LDL cholesterolThe 'bad' cholesterol that can build up in artery walls.
- Non-HDL cholesterolAll the 'bad' cholesterol together: total cholesterol minus HDL.
Quick answers
What is the Cholesterol/HDL ratio blood test?
Cholesterol/HDL ratio (Total cholesterol to HDL cholesterol ratio): Total cholesterol divided by HDL; lower is better. This ratio divides your total cholesterol by your HDL, the 'good' cholesterol. A lower ratio means more of your cholesterol is the protective kind. Most doctors want it under 5, and under 3.5 is considered very good.
What is a normal Cholesterol/HDL ratio level?
For most adults, Cholesterol/HDL ratio is typically under 5 ratio (desirable). Labs differ a little, so the range printed next to your result is the one to go by.
What does a high Cholesterol/HDL ratio mean?
A higher ratio points to higher heart risk, from high total cholesterol, low HDL or both. What it means for you depends on your overall heart risk. Common reasons include low HDL, often with little activity, extra weight or smoking; high LDL or high triglycerides; high blood sugar or type 2 diabetes; and genes: cholesterol levels often run in families. A doctor reads it together with your other results and how you feel.
What should I ask my doctor about my Cholesterol/HDL ratio?
Questions worth taking to the appointment: Is my ratio high because of low HDL or high total cholesterol? What target fits my overall heart risk?
What this page can’t do
It reads each number on its own.
Doctors read results together — ALT with AST, ferritin with hemoglobin, TSH with free T4. A pattern says more than any single flag.
It doesn't know you.
Your age, your medicines, how you feel and your last result all change what a number means.
It doesn't remember.
Close this page and your results are gone. That's on purpose: nothing was ever sent to us.
We also make Vita: Health Coach, an app for those parts. It reads your whole report with your medicines and history in mind, answers follow-up questions in plain words, and keeps your reports in one place — for you and for the people you look after.
Vita: Health Coach on the App StoreSources
- University of Rochester Medical Center — Lipid panel with total cholesterol:HDL ratio
- Mayo Clinic — Cholesterol ratio or non-HDL cholesterol
Stuck on a word? See the medical words. How we choose our sources. More about Vita Health Coach.