Lipid Panel with Total Cholesterol: HDL Ratio
Does this test have other names?
Total cholesterol, HDL cholesterol, cholesterol HDL ratio, cholesterol panel
What is this test?
This group of tests measures the amount of cholesterol and triglycerides in your blood.
Cholesterol and triglycerides are fats (lipids). This panel measures:
HDL ("good") cholesterol
LDL ("bad") cholesterol
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 5 years.
Why do I need this test?
You may need this test as part of your regular medical checkup. You may have this test done more often than every 5 years if:
Your total cholesterol is above 200 mg/dL
You are a woman older than 50
You are a man older than 45
You have other risk factors for coronary heart disease
Your HDL cholesterol is less than 40 mg/dL
What other tests might I have along with this test?
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.
What do my test results mean?
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results 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 have twice the risk for heart disease as 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
If your number is less than 25 mg/dL, your risk for coronary heart disease is doubled.
If your number is between 60 and 74 mg/dL, your risk for coronary heart disease is below average.
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 one of the numbers.
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.
How is this test done?
The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand.
Does this test pose any risks?
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.
What might affect my test results?
Many things can affect your results. These include medicines, diet, physical activity, pregnancy, and recent heart attacks.
How do I get ready for this test?
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 illicit drugs you may use.
October 11, 2017
HDL-cholesterol: Clinical aspects of abnormal values. UpToDate, High-Density Lipoprotein Cholesterol. Manual of Laboratory & Diagnostic Tests. Fischbach. 2004, 7th ed., pp. 423-5., Screening for lipid disorders in adults. UpToDate
Fraser, Marianne, MSN, RN,Haldeman-Englert, Chad, MD