Your blood cholesterol level can help indicate whether you’re at risk for heart attack, stroke, or other types of cardiovascular disease.
You calculate total cholesterol by adding up the following numbers:
- high-density lipoprotein (HDL), or good cholesterol
- low-density lipoprotein (LDL), or bad cholesterol
- 20 percent of your triglycerides, a type of fat carried in your blood
Your cholesterol ratio is calculated by dividing your total cholesterol by your HDL number.
For instance, if your total cholesterol is 180 milligrams per deciliter (mg/dL) of blood and your HDL is 82 mg/dL, your cholesterol ratio is 2.2.
According to StatPearls, you should try to keep your cholesterol ratio below 5, with the ideal cholesterol ratio being 3.5. That said, the ideal cholesterol ratios for men and women may differ.
The ideal total cholesterol level for an adult is
Women typically have higher levels of HDL than men. The ideal HDL level is at least 40 mg/dL in men and at least 50 mg/dL in women. This means that men and women may want to aim for cholesterol ratios of 5 and 4, respectively.
The researchers found that women with a cholesterol ratio of 3.5 or below had the lowest risk of AMI. In comparison to women with a cholesterol ratio of 3.5 or below:
- women with a cholesterol ratio of 3.5 to 4.0 were 14 percent more likely to experience AMI
- women with a cholesterol ratio of 4.0 to 5.0 were 46 percent more likely to experience AMI
- women with a cholesterol ratio of 5.0 or above were 89 percent more likely to experience AMI
HDL, or good cholesterol, carries
On the other hand, LDL, or bad cholesterol, transports cholesterol to your arteries. It can lead to a buildup of plaque in the arteries, resulting in poor blood flow and a condition known as atherosclerosis.
Cholesterol, even the bad kind, still has its benefits. Your body needs cholesterol for many important functions, such as producing bile acids or hormones such as estrogen and testosterone. However, your liver naturally produces enough cholesterol that you don’t have to worry about getting it through your diet.
Optimal HDL levels are over 40 mg/dL for men and over 50 mg/dL for women, according to Germany’s
An optimal LDL level is under 100 mg/dL, according to the
Mathematically speaking, you can improve your cholesterol ratio by either reducing your total cholesterol level or increasing your HDL level. Here are a few tips for improving your cholesterol ratio.
Eat more soluble fiber
Eating more fiber is good for your overall cardiovascular health. Soluble fiber in particular may help lower your blood cholesterol levels, according to research. Get more soluble fiber in your diet by choosing foods like:
- black beans
- apples, which are rich in the soluble fiber pectin
Eat fewer unhealthy fats
Avoid or limit foods that contain trans fats or certain saturated fats, like the kind found in processed foods. They’re associated with higher levels of total cholesterol and LDL, and lower levels of HDL.
Exercise, and aerobic exercise in particular, may help to raise your HDL levels, according to
According to studies, smoking cigarettes may increase your LDL and total cholesterol levels and
These medications lower levels of LDL and total cholesterol in your body. They may also help boost your HDL levels.
Examples of statins include:
- atorvastatin (Lipitor)
- lovastatin (Altoprev)
- pitavastatin (Livalo)
- rosuvastatin (Crestor)
According to the
- with a history of cardiovascular disease caused by atherosclerosis
- with an LDL level of 70–189 mg/dL and a 10-year risk of cardiovascular disease — caused by atherosclerosis — that exceeds 5 percent
- with an LDL level over 190 mg/dL
- who have diabetes and are 40–75 years old
Speak with a doctor about whether statins are right for you.
Taking these medications is usually a lifelong commitment. Safely discontinuing their use requires you to work closely with your doctor.
Your cholesterol ratio clarifies the picture of your risk of heart disease.
A 2020 study looked at the effect of different cholesterol measurements on people’s risk of atherosclerotic cardiovascular disease. The researchers found that people with a higher cholesterol ratio despite low LDL or non-HDL levels were still at increased risk of atherosclerotic cardiovascular disease.
People with a higher cholesterol ratio and low LDL or non-HDL levels were also at a greater risk of atherosclerotic cardiovascular disease when compared to people with a lower cholesterol ratio and high LDL or non-HDL levels.
This suggests that clinicians should prioritize the cholesterol ratio over just the LDL and non-HDL cholesterol levels when assessing cardiovascular risk.
However, the ratio alone isn’t enough to assess what treatment will be best if your risk is high. A doctor will still take your total cholesterol into account when determining the correct mix of diet, exercise, and medication to bring your numbers into the desirable range.