Lipid Panel with Total Cholesterol: HDL Ratio

Total cholesterol, HDL cholesterol, cholesterol HDL ratio, cholesterol panel

This group of tests measures the amount of cholesterol and triglycerides in your blood.

Cholesterol and triglycerides are fats (lipids). This panel measures:

• Total cholesterol

• HDL ("good") cholesterol

• LDL ("bad") cholesterol

• Triglycerides

Total cholesterol is a measurement of both good and bad cholesterol. LDL cholesterol moves cholesterol into your arteries. HDL cholesterol moves cholesterol out of your arteries. A high HDL cholesterol number lowers your risk for coronary heart disease. A high LDL cholesterol number raises your risk for coronary heart disease.

By comparing your total cholesterol number with your HDL cholesterol number, your healthcare provider can get another number called your total-cholesterol-to-HDL ratio. These combined numbers help figure out your risk for coronary heart disease and stroke.

The American Heart Association recommends that all adults older than 20 have a lipid profile once every 4 to 6 years as long as your risk for cardiovascular disease stays low. You may need to have your blood tested more often if you have risk factors for heart disease or stroke. Talk with your healthcare provider.

You may need this test as part of your regular medical checkup. You may have this test done more often if:

• Your total cholesterol is above 200 mg/dL

• You have other risk factors for coronary heart disease

• Your HDL cholesterol is less than 40 mg/dL

Your healthcare provider may also order other tests to check for other coronary heart disease risk factors. These may include other blood tests. They may also include tests for diabetes and diseases of your thyroid, liver, or kidneys.

Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.

Results are given in milligrams per deciliter (mg/dL). Here are the ranges for total cholesterol in adults:

• Normal: less than 200 mg/dL

• Borderline high: 200 to 239 mg/dL

• High: at or above 240 mg/dL

If your total cholesterol is high, you may have a higher risk for heart disease than a person with normal total cholesterol.

Here is the adult range for HDL cholesterol:

• Normal: 35 to 65 mg/dL for men, 35 to 80 mg/dL for women

A low HDL cholesterol level is associated with an increased risk for coronary heart disease.

Your total-cholesterol-to-HDL ratio can be figured out by dividing your total cholesterol number by your HDL cholesterol number. Together, these numbers provide more information about your coronary heart disease risk than knowing only 1 of the numbers.

In general:

• The higher the ratio, the higher the risk.

• Most healthcare providers want the ratio to be below 5:1.

• A ratio below 3.5:1 is considered very good.

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. 

Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore. 

Many things can affect your results. These include medicines, diet, physical activity, pregnancy, and recent heart attacks.

You will need to not eat or drink anything but water for 9 to 12 hours before this test. Also let your healthcare provider know if:

• Your diet has changed a lot in the past week

• You've been drinking alcohol in the last 2 days

• You've had a heart attack in the last 3 months

Be sure your provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use.