Cholesterol Ratio: Men Vs. Women, HDL Vs. LDL, And More

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Understanding the Cholesterol Ratio: What It Is and Why It’s Important

Medically reviewed by Megan Soliman, MD — Written by The Healthline Editorial Team — Updated on November 19, 2024

Men vs. women
HDL vs. LDL
Improve your ratio
Takeaway

Your blood cholesterol level can help indicate whether you’re at risk for heart attack, stroke, or other types of cardiovascular disease.

You calculate total cholesterol by adding up the following numbers:

high-density lipoprotein (HDL), or good cholesterol
low-density lipoprotein (LDL), or bad cholesterol
20 percent of your triglycerides, a type of fat carried in your blood

Your cholesterol ratio is calculated by dividing your total cholesterol by your HDL number.

For instance, if your total cholesterol is 180 milligrams per deciliter (mg/dL) of blood and your HDL is 82 mg/dL, your cholesterol ratio is 2.2.

Ratio for men vs. women

According to StatPearls, you should try to keep your cholesterol ratio below 5, with the ideal cholesterol ratio being 3.5. That said, the ideal cholesterol ratios for men and women may differ.

The ideal total cholesterol level for an adult is 200 mg/dL or less.

Women typically have higher levels of HDL than men. The ideal HDL level is at least 40 mg/dL in men and at least 50 mg/dL in women. This means that men and women may want to aim for cholesterol ratios of 5 and 4, respectively.

A 2019 study looked at the relationship between the cholesterol ratio and acute myocardial infarction (AMI) in Swedish women in their 50s. AMI is another term for heart attack. Data was collected between 1995 and 2000.

The researchers found that women with a cholesterol ratio of 3.5 or below had the lowest risk of AMI. In comparison to women with a cholesterol ratio of 3.5 or below:

women with a cholesterol ratio of 3.5 to 4.0 were 14 percent more likely to experience AMI
women with a cholesterol ratio of 4.0 to 5.0 were 46 percent more likely to experience AMI
women with a cholesterol ratio of 5.0 or above were 89 percent more likely to experience AMI

HDL vs. LDL

HDL cholesterol, or good cholesterol, carries about 25 to 33 percent of the free cholesterol that’s circulating in your body back to your liver. Afterward, the liver moves the LDL out of your body, which helps prevent it from clogging your arteries.

On the other hand, LDL cholesterol, or bad cholesterol, transports cholesterol to your arteries. It can lead to a buildup of plaque in the arteries, resulting in poor blood flow and a condition known as atherosclerosis.

Cholesterol, even the bad kind, still has its benefits. Your body needs cholesterol for many important functions, such as producing bile acids or hormones such as estrogen and testosterone. However, your liver naturally produces enough cholesterol that you don’t have to worry about getting it through your diet.

According to Germany’s Institute for Quality and Efficiency in Health Care, optimal HDL levels for men are over 40 mg/dL and for women over 50 mg/dL.

Additionally, an optimal LDL level is under 100 mg/dL, according to the Centers for Disease Control and Prevention (CDC).

How to improve your ratio

Mathematically speaking, you can improve your cholesterol ratio by either reducing your total cholesterol level or increasing your HDL level. Here are a few tips for improving your cholesterol ratio.

Eat more soluble fiber

Eating more fiber is good for your overall cardiovascular health. Soluble fiber, in particular, may help lower your blood cholesterol levels, according to research. Get more soluble fiber in your diet by choosing foods like:

black beans
lentils
oats
apples, which are rich in the soluble fiber pectin

Eat fewer unhealthy fats

Avoid or limit foods that contain trans fats or certain saturated fats, like the kind found in processed foods. These are associated with higher levels of total cholesterol and LDL and lower levels of HDL.

Exercise

Exercise, and aerobic exercise in particular, may help to raise your HDL levels, according to research. Incorporate some of the following aerobic activities into your regular workout routine:

running
walking
cycling
swimming
jumping rope
kickboxing

Quit smoking

According to studies, smoking cigarettes may increase your LDL and total cholesterol levels and decrease your HDL levels. If you currently smoke, get help to quit.

Consider statins

These medications lower levels of LDL and total cholesterol in your body. They may also help boost your HDL levels.

Examples of statins include:

atorvastatin (Lipitor)
lovastatin (Altoprev)
pitavastatin (Livalo)
rosuvastatin (Crestor)

According to the American Heart Association (AHA), adults who may benefit from statins include people:

with a history of cardiovascular disease caused by atherosclerosis
with an LDL level of 70–189 mg/dL and a 10-year risk of cardiovascular disease — caused by atherosclerosis — that exceeds 5 percent
with an LDL level over 190 mg/dL
who have diabetes and are 40–75 years old

Speak with a doctor about whether statins are right for you.

Taking these medications is usually a lifelong commitment. Safely discontinuing their use requires you to work closely with your doctor.

The bottom line

Your cholesterol ratio clarifies the picture of your risk of heart disease. However, the ratio alone isn’t enough to assess what treatment will be best if your risk is high.

A doctor will still consider your total cholesterol when determining the correct mix of diet, exercise, and medication to bring your numbers into the desirable range.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Bailey A. (2021). Biochemistry, high density lipoprotein.https://www.statpearls.com/articlelibrary/viewarticle/22879
Calling S, et al. (2019). The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women’s health in the Lund area (WHILA): A 17-year follow-up cohort study.https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-019-1228-7
Cholesterol medications. (2020).https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia/cholesterol-medications
Fiber. (n.d.).https://www.hsph.harvard.edu/nutritionsource/carbohydrates/fiber
Hallit S, et al. (2017). Effect of exclusive cigarette smoking and in combination with waterpipe smoking on lipoproteins.https://www.sciencedirect.com/science/article/pii/S2210600617302496
HDL (good), LDL (bad) cholesterol and triglycerides. (2020).https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides
He B-M, et al. (2013). Effects of cigarette smoking on HDL quantity and function: Implications for atherosclerosis.https://pubmed.ncbi.nlm.nih.gov/23852759
High cholesterol: Overview. (2017).https://www.ncbi.nlm.nih.gov/books/NBK279318
LDL and HDL cholesterol: "Bad" and "good" cholesterol. (2020).https://www.cdc.gov/cholesterol/ldl_hdl.htm
Quispe R, et al. (2020). Total cholesterol/HDL-cholesterol ratio discordance with LDL-cholesterol and non-HDL-cholesterol and incidence of atherosclerotic cardiovascular disease in primary prevention: The ARIC study.https://academic.oup.com/eurjpc/article/27/15/1597/5950564
Ruiz-Ramie JJ, et al. (2020). Effects of exercise on HDL functionality.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492243
Soliman GA. (2019). Dietary fiber, atherosclerosis, and cardiovascular disease.https://www.mdpi.com/2072-6643/11/5/1155/htm

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Medically reviewed by Megan Soliman, MD — Written by The Healthline Editorial Team — Updated on November 19, 2024

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Ratio for men vs. women

HDL vs. LDL

How to improve your ratio

Eat more soluble fiber

Eat fewer unhealthy fats

Exercise

Quit smoking

Consider statins

The bottom line

How we reviewed this article:

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