Cholesterol Ratio: Calculating and Interpreting it by Yourself

Total cholesterol, HDL, LDL, these are common terms you certainly know about or at least heard once. What’s about cholesterol ratio? Don’t worry! It is nothing confusing. It is simply the number obtained by dividing your Total Cholesterol (TC) by your High-Density Lipoproteins (HDL) level. It is a very useful number in helping to predict a person’s risk level of developing atherosclerosis, or hardening of the arteries. However, it is not a good indicator for deciding the most suitable treatment you should have to reduce their level of heart disease risk. In order to assess this properly and work up a plan for treatment purposes, it is important to know the absolute numbers for all your cholesterol levels.


As an example, if your TC is 158 mg/dL and your HDL is 43 mg/dL, your cholesterol ratio would be 3.7. Now, according to the AHA (American Heart Association), the number we are aiming for is below 5, with the ideal being close to 3.5. In other words, a lower TC/HDL ratio is better since your aim is to increase your HDL cholesterol numbers and reduce your total cholesterol overall.

lipid panel results with cholesterol ratio

Same Numbers, Different Outcome

Taking the example described above and examining it more closely, you can see that two persons may have same total cholesterol reading but their cholesterol ratio may differ, stressing the fact that your goal is to consistently raise your HDL number since this will affect your ratio drastically. To illustrate that, if someone had a total cholesterol level of 180 and HDL level of 30 (while the level should be over 40 and over 50 for women), the ratio would be at 6 putting you in the risky category. But, with a higher HDL of 50, the score will be 3.6, practically optimal.

Difference between Men and Women

Due to the fact that women naturally have higher HDL levels than men, their proportion of TC/HDL is generally lower. A cholesterol ratio of 4.4 would indicate average risk for developing heart disease for a woman while for men, the average risk number is 5. If that ratio approaches 7 for women, their risk for heart disease doubles, while 3.3 is the ideal number to halve that same risk. For men, if the proportion reaches 9.6, the risk for heart disease doubles, while accordingly, having a number closer to 3.4 would cut their overall risk to half.


Apart from the TC/HDL number, there is another number which is the proportion of HDL to LDL. You can calculate this yourself by taking your HDL level and dividing it by your LDL number. So for example, if one has an HDL level of 40 mg/dL and LDL of 140 mg/dL, the HDL/LDL ratio would be about 0.29. The goal here is to keep this number above 0.3, with an ideal result of having it closer to or above 0.4.

The HDL/LDL proportion can be considered to be a much purer ratio than TC/HDL simply because it directly compares the “good” cholesterol versus the “bad” cholesterol levels while dividing TC by HDL could seem illogical as TC = HDL + LDL + 1/5 TG.
There is much debate though amongst doctors and cholesterol research scientists on using HDL/LDL score for heart disease development risk assessment. Also, as obtaining LDL levels is more difficult and expensive than the total cholesterol, doctors generally use TC/HDL


Aiming to get your LDL score below 100 and even 80 is still highly recommended regardless of whether your ratio is favorable or not. This is especially crucial for people with established coronary artery disease, those that are genetically predisposed to high cholesterol, diabetics, people having high blood pressure and smokers.