HDL Vs. LDL Cholesterol: Differences, Ranges, And Ratios

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Differences between HDL (good) and LDL (bad) cholesterol

Medically reviewed by Daniel Jennings, PA-C — Written by Jo Lewin R.N. — Updated on March 31, 2025

HDL vs. LDL
Ideal ranges
Ratios
Causes of high LDL cholesterol
Reduce LDL levels
Increase HDL levels
FAQ
Summary

Low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, collects in the walls of the blood vessels, causing them to narrow. High-density lipoprotein (HDL), or “good” cholesterol, moves LDL cholesterol out of the bloodstream.

The two main types of cholesterol are high-density lipoprotein (HDL), or “good” cholesterol, and low-density lipoprotein (LDL), or “bad” cholesterol. Some cholesterol is necessary, but high levels can be dangerous.

Along with smoking and high blood pressure, raised blood cholesterol is one of the main risk factors for heart disease. People can reduce their blood cholesterol with a healthful diet, exercise, and medication.

HDL vs. LDL cholesterol

High angle view of active runners jogging outdoors on pier by sea in early morning. — Halfpoint Images/Getty Images

LDL cholesterol is usually called bad cholesterol. If there is too much LDL cholesterol in the blood, it builds up in the walls of the blood vessels, causing them to narrow and stiffen.

A buildup of LDL cholesterol reduces blood flow and can increase the risk of heart attack or stroke.

HDL, or good cholesterol, can move LDL cholesterol from the blood to the liver, where it is broken down as waste. HDL cholesterol is good cholesterol because it reduces the cholesterol level in the blood.

Higher HDL levels link to a reduction in the risk of heart attack and heart disease.

»Learn more about cholesterol

What are the ideal ranges of LDL and HDL?

The United States measures cholesterol in milligrams per deciliter (mg/dL). The guidelines for healthy cholesterol levels are as follows:

total cholesterol below 200 mg/dL
LDL cholesterol less than 100 mg/dL
HDL cholesterol above 40 mg/dL for men and above 50 mg/dL for women

Different regions and countries may have varying guidelines, so speaking to a doctor about the most accurate and up-to-date ranges is wise.

However, if a patient has had an event before or is considered high risk, then these levels may not apply to them.

Total cholesterol to HDL ratios

The total cholesterol to HDL cholesterol ratio is a way to calculate cardiovascular risk. A high total cholesterol to HDL ratio indicates a higher risk for heart disease. A person can measure it by dividing the total cholesterol by the HDL level.

A desirable ratio is 5:1, and an optimal ratio is 3.5:1. The lower this number is, the healthier a person’s cholesterol levels are.

Total cholesterol fluctuates, so more than one blood test might be necessary for an accurate assessment. Levels can change following a meal, so a blood test is sometimes taken first thing in the morning before breakfast.

Studies suggest that the total cholesterol to HDL ratio is a better marker of the risk of heart disease than LDL cholesterol levels alone.

Non-HDL cholesterol

Another method of assessing cholesterol levels is calculating a non-HDL cholesterol level. A person can measure this by subtracting HDL cholesterol from the total cholesterol.

Similarly to LDL cholesterol, VLDL cholesterol can also build up inside the walls of blood vessels, which is undesirable.

Ideally, non-HDL cholesterol should be less than 130 mg/dL. A higher value increases the risk of heart disease.

Causes of high LDL cholesterol

Causes of high LDL cholesterol include:

Eating a diet high in saturated fat: Diets high in saturated fats can increase LDL cholesterol levels.
Inactivity: Not getting enough exercise can lead to weight gain, which links to an increase in cholesterol levels.
Obesity: People who are overweight have an increased risk of high cholesterol levels.
Medical conditions: Some of these that can affect LDL cholesterol levels include type 2 diabetes, underactive thyroid, liver conditions, and alcohol addiction.
Menopause: For some women, cholesterol levels can rise after menopause.
Genetics: Familial hypercholesterolemia (FH) is an inherited form of high cholesterol that puts people at risk of early heart disease.

Oftentimes, despite as many lifestyle modifications as possible, a person may still have high cholesterol. It can be that the only way to get down to the proper range is with medication. This should not be seen as a failure but a necessity to get a patient into typical levels to mitigate risk.

How to reduce LDL levels

The following lifestyle changes can help lower LDL cholesterol and help reduce the risk of cardiovascular disease:

maintaining a healthy weight
exercising regularly
quitting smoking
using statin therapy when prescribed

People trying to lower their LDL cholesterol should also avoid eating saturated and trans fats. Foods high in saturated fat include:

beef
lamb
pork
poultry, especially with skin
beef fat (tallow)
lard and cream
butter
cheese
ice cream
coconut
palm oil
some baked and fried foods

Other diet tips to prevent LDL levels from creeping up include:

Switch fat sources: Swap saturated fats for nut and seed oils or monounsaturated fats from olive, avocado, and canola oil.
Increase fiber intake: A diet high in fiber can be suitable for total blood cholesterol levels. Soluble fiber found in fruits, vegetables, and oats is particularly beneficial.

How to increase HDL levels

A variety of things can improve HDL cholesterol levels, including:

Omega-3 fatty acids: Omega-3 fatty acids can lower blood cholesterol when consumed as part of a balanced diet. The highest levels of omega-3 fatty acids are in oily fish, such as mackerel, trout, herring, sardines, fresh tuna, salmon, and halibut. The American Heart Association recommends eating two servings of particularly fatty fish weekly.
Regular exercise: Research shows that exercise and physical activity can raise HDL levels.

Frequently asked questions

What happens if your HDL is low?

Low HDL can increase a person’s risk of cardiovascular conditions, such as heart disease and stroke. HDL absorbs cholesterol in the blood and transports it to the liver, which clears it from the body.

A person with low HDL can increase their levels by avoiding smoking, maintaining a moderate body weight, eating a nutritious diet, and getting regular physical activity.

Is an HDL of 35 too low?

Doctors consider an HDL level of 35 very low. Optimal HDL levels are at least 40 mg/dL in males and 50 mg/dL in females. A person with an HDL level of 35 should discuss ways to increase it with a doctor.

Is it better to lower LDL or raise HDL?

It is important to focus on cholesterol management as a whole, including eating a nutritious diet, avoiding saturated fats, and exercising. This can help lower LDL and raise HDL.

Summary

High LDL cholesterol is a risk factor for heart disease but can often occur without symptoms.

People over 40 should arrange a blood test to check their cholesterol levels and total cholesterol to HDL ratio.

Dietary and lifestyle changes can significantly affect HDL and LDL levels. If these levels do not improve with these changes, a doctor may recommend medications.

Cholesterol
Nutrition / Diet
Obesity / Weight Loss / Fitness
Smoking / Quit Smoking

How we reviewed this article:

SourcesMedical News Today 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.

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Calling S, et al. (2021). Total cholesterol/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease: a 17-year follow-up study of women in southern Sweden.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020530/
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Feingold KR. (2023). Obesity and dyslipidemia.https://www.ncbi.nlm.nih.gov/books/NBK305895/
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High cholesterol. (2022).https://www.nhs.uk/conditions/high-cholesterol/
How do I lower my cholesterol? Your 5 top questions answered. (n.d.).https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol/five-top-questions-about-lowering-cholesterol
Ibrahim MA, et al. (2023). Hypercholesterolemia.https://www.ncbi.nlm.nih.gov/books/NBK459188/
Inaraja V, et al. (2020). Lipid profile changes during the menopausal transition [Abstract].https://pubmed.ncbi.nlm.nih.gov/32187130/
Lifestyle changes for heart attack prevention. (2025).https://www.heart.org/en/health-topics/heart-attack/life-after-a-heart-attack/lifestyle-changes-for-heart-attack-prevention
Muscella A, et al. (2020). The effects of exercise training on lipid metabolism and coronary heart disease [Abstract].https://pubmed.ncbi.nlm.nih.gov/32442027/
Rong, S, et al. (2022). Association of low-density lipoprotein cholesterol levels with more than 20-year risk of cardiovascular and all-cause mortality in the general population.https://pubmed.ncbi.nlm.nih.gov/35904192/
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Vaezi Z, et al. (2022). Familial hypercholesterolemia.https://www.ncbi.nlm.nih.gov/books/NBK556009/
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Medically reviewed by Daniel Jennings, PA-C — Written by Jo Lewin R.N. — Updated on March 31, 2025

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HDL vs. LDL cholesterol

What are the ideal ranges of LDL and HDL?

Total cholesterol to HDL ratios

Non-HDL cholesterol

Causes of high LDL cholesterol

How to reduce LDL levels

How to increase HDL levels

Frequently asked questions

What happens if your HDL is low?

Is an HDL of 35 too low?

Is it better to lower LDL or raise HDL?

Summary

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