Understand The Cholesterol Ratio To Keep Your Heart Healthy

Health check-ups should be a regular routine for each and every one of us. Among the myriad tests, getting your cholesterol level checked becomes increasingly important as you age. A cholesterol check involves a blood test routine on an empty stomach. The results involve a bunch of numbers that only your doctor can make sense of. While depending on your doctor is good, it is good to know how to read what’s wrong with your body, at least on a basic level.

Get Your Basics Right

understand the different kinds of cholesterol


Just hearing the word “cholesterol” should not create fear in you because not all cholesterol is bad. Cholesterol is found in all of us and is necessary for the synthesis of various bile acids and hormones. Particles called lipoproteins help carry cholesterol via the bloodstream, from the liver (where it is made) to the cells.

Basically, there are three types of lipids in the blood: high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), and triglycerides.1


1. High-Density Lipoprotein Cholesterol (HDL-C)

HDL-C is also known as “good cholesterol” as it removes LDL-C from the arteries and carries it to the liver to be removed. It makes up 20–30% of the total body cholesterol. Having a high level of HDL-C (60 or above) is regarded as good for the heart. Low levels (lesser than 40) indicate an increased risk of heart disease.

2. Low-Density Lipoprotein Cholesterol (LDL-C)

LDL-C is the sticky cholesterol that contributes to plaque formation in the arteries. Plaque clogs the arteries and makes them less flexible. Hence, LDL-C is known as the “bad cholesterol” and makes up 60–70% of the total cholesterol. It goes without saying that low levels of LDL-C is better for your heart.


3. Triglycerides

Triglyceride is the fat that is most commonly found in the body. A combination of high triglyceride level and high LDL or low HDL cholesterol in the body can be linked with atherosclerosis. For a healthy body, you should have less than 150 mg/dL of triglyceride.

Learn About The Cholesterol Numbers

cholesterol ratio is a good indicator of your risk of heart disease


It’s important to work out your cholesterol ratio as it is a good indicator of your risk of heart disease. Cholesterol ratio is calculated by dividing the total cholesterol by the high-density lipoprotein level.2 Here’s how you can read it:

  • Ideal total cholesterol level: 200 mg/dL or below
  • Borderline high: between 200 and 239
  • High level: 240 and above

However, a desirable total cholesterol level doesn’t exempt you from the risk of heart disease. Total cholesterol level is just a glimpse at your heart health that includes both the bad and the good types. Even if you are in the desirable category, you could have unhealthy levels of LDL and HDL. So, treatment cannot be based solely on the total cholesterol number.


To find out the cholesterol ratio, you must divide the HDL cholesterol number by your total cholesterol number. The smaller this number, the better. For example, if your total cholesterol is 180 and HDL is 60, the ratio would be 3.1 (180 ÷ 60 = 3.1). If your HDL is low, let’s say 35, then the total cholesterol-to-HDL ratio would be higher at 5.1. Ideally, your cholesterol ratio should be below 5 (3.5 would be the best case scenario) according to the American Heart Association.3

What The Numbers Mean

What affects cholesterol level


Those who have blood triglycerides on the higher side tend to have lower HDL cholesterol. Everything from genetic factors, being overweight, smoking, type 2 diabetes, and being sedentary can cause low HDL cholesterol. Women usually have higher levels of HDL cholesterol than men.4

For men, a reading of 5 indicates average risk for heart disease, 3.4 indicates half the average risk, and 9.6 indicates double the average risk. Since women tend to have higher HDL levels, for them, a reading of 4.4 signals average risk, 3.3 signals half the average risk, and 7 signals double the risk. In case your total cholesterol level is high and your total-to-HDL ratio is low, it may be less alarming.


The level of triglyceride that is considered normal varies by age and sex.5 Those with high triglycerides tend to have a high total cholesterol level (which includes low HDL cholesterol level and high LDL cholesterol level). A majority of those who have diabetes or heart disease also have high triglyceride levels.

Being overweight, physical inactivity, smoking cigarettes, drinking excess alcohol, a diet full of carbs, genetic disorders or certain diseases can cause elevated triglyceride levels. So how do you keep your heart healthy? Maintain a low level of LDL cholesterol and eat less saturated and trans fats. Bring about some lifestyle changes to reduce triglyceride levels.