Beyond Cholesterol: Do You Know Your Cholesterol Ratio?

Beyond Cholesterol: Do You Know Your Cholesterol Ratio?

(Last Updated On: April 20, 2019)

istock_000009254955xsmallMany people know what their total cholesterol is, but not everybody knows their cholesterol ratio. Cholesterol ratio is another factor that determines your risk of getting heart disease. When you get your lipid levels checked by a doctor, they calculate more than just your total cholesterol level. They also determine your HDL, the level of “good” cholesterol in your bloodstream, your LDL or “bad” cholesterol – as well as your cholesterol ratio. It’s important to know each of these numbers to understand your risk for heart disease.

Do You Know Your Cholesterol Ratio?

When you have your lipid levels checked at your doctor’s office the lab report lists your total HDL cholesterol, LDL cholesterol, and cholesterol ratio. You can calculate your cholesterol ratio yourself if you know your total cholesterol and HDL cholesterol level. Simply divide the reading for your total cholesterol by your HDL. For example, if your total cholesterol is 200 and your HDL is 50, your cholesterol ratio is 4 to 1. That’s a good ratio since the American Heart Association recommends keeping your cholesterol ratio below 5 to 1.

A higher HDL level lowers your cholesterol ratio, and a higher HDL is a positive in terms of heart disease risk. This is because HDL cholesterol helps to “clean up” the walls of blood vessels by removing excess cholesterol and carrying it back to the liver where it can be broken down. That means there’s less cholesterol hanging around to narrow and block your arteries and lead to a heart attack or stroke. HDL levels of between 40 and 60 are acceptable, but above 60 are optimal for heart health.

How to Improve Your Cholesterol Ratio

You can improve your ratio by lowering your total cholesterol or raising your HDL level. To do this you want to lower your LDL level, the bad form of cholesterol that increases the risk of heart disease. You can do it to some degree by losing excess weight, adding more fiber to your diet and by replacing saturated fat from animal sources with monounsaturated ones from nuts, seeds, and olive oil and omega-3 fats from fatty fish. Eliminating most processed foods helps many people reduce their cholesterol level. Some people who don’t respond to dietary changes need medication to get their LDL cholesterol down to a desirable level. In people who don’t have heart disease, an LDL cholesterol level of 130 or lower is acceptable.

The other way to improve your cholesterol ratio is to raise your HDL level. One of the best ways to do this is through exercise. Aerobic exercise is most effective and how long you work out matters. To get the benefits of a higher HDL, you need to exercise for a minimum of 30 minutes most days of the week. In terms of heart health, high-intensity exercise offers more benefits than a leisurely walk. Drinking one to two glasses of alcohol a day, preferably red wine because of its heart benefits, also helps to raise HDL cholesterol levels. If you smoke, kick the habit. It lowers HDL levels.

The Bottom Line?

Your total cholesterol level doesn’t tell the whole story. You need to know not only your total cholesterol levels but your HDL level, LDL level, and your cholesterol ratio as well. Ask your doctor about these numbers.



Arch Intern Med 2007; 167:999-1008.
Mayo Clinic. “How Important is Cholesterol Ratio?”
WebMD. “HDL Cholesterol: The Good Cholesterol”


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