What Is The Total Cholesterol To HDL Ratio?

When people discuss their cholesterol levels they are often speaking of their total cholesterol.  It is ideal to have that total number down to 200 mg/dL or lower.  People with a total cholesterol count of 200-239 mg/dL are considered as having borderline high risk for a heart attack.  A number that is 240 mg/dL or higher is considered as high risk for heart attack.

However, as we have learned through the studies performed over the last couple decades, it is not necessarily the total cholesterol that matters, but rather how much bad cholesterol (LDL) and good cholesterol (HDL) we have.  With routine blood tests, LDL cholesterol levels are not measured.  Instead, total cholesterol and HDL cholesterol (the good cholesterol) is measured.  From these numbers we can calculate the total cholesterol to HDL ratio, which is a fast and easy way to get a clear picture of our heart attack risk.  

What Is The Total Cholesterol To HDL Ratio?

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Calculating the total cholesterol to HDL ratio is very simple.  No specific knowledge or any special cholesterol ratio calculator is needed.  Just take the total cholesterol number and divide it by the HDL number.  All you need is a standard calculator – the computer you are reading this on has a basic calculator that you can use.

For instance, if your total cholesterol is 212 mg/dL and your HDL is 42 mg/dL, your cholesterol/HDL ratio would be 212/42 = 5.047.  You can then take this number and compare it to the following chart.  Be aware that there are several charts available that provide risk of heart attack based on your ratio number.  Be sure to use a chart that your doctor recommends.  The chart below is based on the recommendations of the Framingham Heart Study.

Total Cholesterol To HDL Ratio

Risk Of Heart Attack









Moderate 9.6


This ratio should only be used as a rough guideline.  If you find yourself with a total cholesterol to HDL ratio that indicates a higher than average risk of heart attack you should discuss this with your doctor.  It is likely that more thorough blood tests will be conducted to get a better understanding of your cholesterol levels and heart attack risk.