Cholesterol readings don’t have to be confusing. There is total cholesterol, HDL cholesterol, and LDL cholesterol. There’s also non-HDL cholesterol.

What exactly is non-HDL cholesterol, how is it different from the other cholesterol readings, and what do you need to know about it?

As you might know, not all cholesterol is bad. Your body needs some cholesterol in order to function properly. But you don’t want too much of it, particularly the bad kinds.

Non-HDL cholesterol, also known as non-HDL-C, is a way of measuring how much of the bad kinds of cholesterol you have in your blood. It’s also a helpful way for your doctor to evaluate your risk of heart disease.

Keep reading to learn about what makes up your non-HDL cholesterol number, how it affects heart health, and how you can reduce this type of cholesterol.

To determine your cholesterol levels, your doctor will order a blood test called a lipid panel. This test measures the cholesterol in your blood. Some doctors may order a panel of tests that covers all the fats in your blood, including cholesterol and triglycerides.

When you get a lipid panel with non-HDL cholesterol, your doctor is measuring your HDL and LDL cholesterol. HDL is also known as the “good” cholesterol, while LDL is often called the “bad” cholesterol.

Experts measure non-HDL cholesterol by subtracting your HDL cholesterol from your total cholesterol.

Your doctor may request this test to offer strategies to reduce your risk of heart disease. You might be at a higher risk of heart disease if you have high total cholesterol, or if you have:

Also, some lifestyle factors may lead your doctor to measure your non-HDL cholesterol:

You may get other tests along with the lipid panel with non-HDL cholesterol, the University of Rochester Medical Center says. To further assess your heart health, your doctor may also request:

All of these tests give your doctor the information they need to help you improve and support your heart health.

Many people want to lower the level of cholesterol in their blood. But total cholesterol doesn’t tell the whole story.

To better understand your heart disease risks, total cholesterol is broken down into:

Let’s take a closer look at each type of cholesterol and what it means.

HDL cholesterol

HDL is commonly referred to as the “good” cholesterol. According to the Centers for Disease Control and Prevention (CDC), that’s because it transports non-HDL cholesterol from the bloodstream to the liver. The liver then removes non-HDL cholesterol from the body. This helps prevent plaque from building up in your arteries.

Having high HDL naturally is good for your health. Some medications, like niacin, can raise your HDL. But a 2017 study showed that taking niacin to increase HDL was not effective at preventing heart attacks.

LDL cholesterol

LDL is sometimes called “bad” cholesterol. If you have too much, it can clog your arteries and restrict blood flow. This can lead to a heart attack or stroke. You want your LDL cholesterol to be as low as possible.

Triglycerides

Triglycerides are a kind of fat you get from food. According to the University of Rochester Medical Center, extra triglycerides can pile up when you eat more calories than you burn off.

High triglyceride levels in the blood have been linked to heart disease. But other conditions, like diabetes and obesity, often accompany high triglyceride levels. In a 2019 study, researchers weren’t sure if triglycerides may cause heart disease or if these other conditions may be responsible.

Like LDL, the goal is to keep triglyceride levels low.

Related to triglycerides are very low-density lipoproteins (VLDL), which are made in the liver. VLDL won’t show up on your report because there’s no way to accurately measure it. It’s typically estimated as a percentage of the triglyceride value. This is important because VLDL transports triglycerides. Research has shown that over time, VLDL can turn into LDL cholesterol.

Non-HDL cholesterol

As the name implies, non-HDL cholesterol is basically your HDL, or “good,” cholesterol number subtracted from your total cholesterol number. In other words, it’s a measure of all the “bad” types of cholesterol. Ideally, you want this number to be lower rather than higher.

The higher your non-HDL cholesterol, the higher your risk of heart disease.

A study published in 2018 involved more than 36,000 people with a low 10-year risk of cardiovascular disease. A long-term follow-up found that LDL and non-HDL readings of more than 160 mg/dL were each linked with a 50 to 80 percent increased relative risk of cardiovascular disease mortality.

For other types of cholesterol, the following CDC guidelines apply if you don’t have heart or blood vessel disease:

Recommended cholesterol levels
Total cholesterolless than 200 mg/dL
LDL cholesterolless than 100 mg/dL
HDL cholesterolgreater than or equal to 60 mg/dL
Triglyceridesless than 150 mg/dL

Your doctor may have different goals for you if you’re at a high risk of heart disease or have already had heart disease.

Keep in mind that the American Heart Association and the American College of Cardiology are both phasing out the concept of target LDL and non-HDL levels. Instead, these levels are being replaced with a risk calculator. This guideline calculates the 10-year risk of cardiovascular disease for adults without known cardiovascular risk and diabetes.

In this case, medical professionals will look at an LDL of 190 or above and treat that person with statin. This guideline takes into account whether someone has cardiovascular disease.

If your non-HDL cholesterol is high, you may be at a higher risk of developing atherosclerosis, or narrowing of the arteries. Non-HDL cholesterol increases your risk of heart disease and:

According to the CDC, the risk of heart disease may be even greater if you:

Studies are beginning to highlight the importance of non-HDL cholesterol in assessing cardiovascular risk.

For example, in a 2016 study, researchers looked at data from 9 clinical trials involving people with coronary disease. They found that achieved non-HDL cholesterol was more strongly associated with disease progression than LDL.

A 2017 study involved more than 4,800 men and included a 22-year follow-up. The researchers concluded that when it comes to predicting cardiovascular disease mortality, non-HDL cholesterol may be more significant than LDL.

You get all the cholesterol you need from your liver. You also get some from foods like meat, poultry, dairy products, and saturated oils used in baked goods. These foods also prompt your liver to make more cholesterol.

To reduce your overall cholesterol levels, the CDC recommends that you limit your intake of saturated fats. That means going light on fatty meat and full-fat dairy products.

It’s also important to avoid trans fats. These may be listed as partially hydrogenated vegetable oil on food labels. You can find them in:

  • Baked goods: store-bought cookies, cakes, pastries, frozen pies
  • Snack foods: crackers, microwaveable popcorn, frozen pizza crusts, meat pies
  • Fried fast foods: fried chicken, french fries, fried noodles, battered fish
  • Vegetable shortening: often used in baked goods as a cheap alternative to butter
  • Stick margarine: made from hydrogenated vegetable oils
  • Non-dairy coffee creamers: used as a substitute for milk and cream in coffee, tea, and other hot beverages

Instead of eating processed foods, try to focus on eating more whole foods, if they’re available to you. These include fresh fruits and vegetables, nuts, seeds, and whole grains. You can also look for healthy sources of protein, like fish, skinless chicken, and lean red meat.

Some foods that may help improve LDL cholesterol include:

  • oatmeal and oat bran
  • kidney beans
  • Brussels sprouts
  • apples and pears
  • almonds
  • avocados

Some foods that may help lower triglycerides include:

  • fish high in omega-3 oils, like salmon, mackerel, herring, tuna, and trout
  • walnuts
  • flaxseed oil
  • canola oil

Other ways to improve your cholesterol include:

  • exercising at a moderate level of activity for at least 30 minutes a day, 5 times a week
  • avoiding smoking
  • limiting alcohol intake
  • maintaining a moderate weight

If lifestyle changes aren’t enough, your doctor may prescribe cholesterol-lowering medications.

High HDL cholesterol is helpful, but high non-HDL cholesterol may mean you’re at an increased risk of heart disease.

Certain lifestyle changes involving diet, exercise, and not smoking may be able to help you manage your non-HDL cholesterol. If that doesn’t work, medications are an effective way to help control cholesterol. If you don’t know your cholesterol numbers, talk with your doctor about getting tested.