Normal range: 0 – 4.5 (lower is better)
The cholesterol/HDL ratio divides your total cholesterol by your HDL and provides a quick snapshot of cardiovascular risk. Values above 4.5 are associated with elevated risk, while below 3.5 is favorable. It is more informative than total cholesterol alone because it accounts for how much of your cholesterol is protective HDL versus potentially harmful LDL and VLDL.
A normal Chol/HDL is 0 – 4.5. Lower is better.
A high ratio results from elevated total cholesterol, low HDL, or both. The most common pattern is low HDL from inactivity and poor diet combined with high LDL from saturated fat intake. Improving either side (raising HDL through exercise or lowering LDL through diet) will improve the ratio.
Because this is a derived ratio, all the lifestyle changes and medications that affect total cholesterol and HDL individually apply here. Regular exercise, dietary improvements, weight loss, and quitting smoking are the most effective lifestyle approaches. Statins primarily improve the ratio by lowering the numerator (total cholesterol).
This ratio compares your total cholesterol to your “good” HDL cholesterol. A lower ratio means lower heart disease risk.
Cholesterol/HDL Ratio tends to fall with age (correlation with age, r = -0.10). The chart below shows the median by 5-year age bin and a linear trend line.
Chol/HDL is most highly correlated with Non-HDL Cholesterol and Apolipoprotein B. Here are the top biomarkers correlated with Chol/HDL, based on 500,000 tests done by Empirical Health.
The percentage shows how strongly two biomarkers move together. A higher number means the relationship is stronger. Green = rises and falls together. Orange = one rises as the other falls.
Chol/HDL isn't ordered on its own — it's derived from a standard lipid panel, which runs about $30–$60 at Quest or LabCorp, or $190 as part of a 100+ biomarker panel from Empirical Health.
You can measure your Chol/HDL for at 2,200+ testing locations across the US. Click below and enter your zip code to browse locations near you.
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