Total Cholesterol:HDL Ratio

What is the total cholesterol:HDL ratio?

Total Cholesterol:HDL-C (TC:HDL) is an important metric of cardiovascular health that compares bad and good cholesterol. It is calculated by dividing your total cholesterol level by your HDL-C level.

Why is the total cholesterol:HDL ratio important?

The higher the TC:HDL ratio, the greater the risk of cardiovascular events. Total cholesterol is calculated by adding LDL-C (“bad” cholesterol), HDL-C (“good” cholesterol), and 20% of triglycerides. Even if HDL-C is high individually, you could still be at risk for cardiovascular events if LDL-C is even higher. Thus, the ratio can assess your risk much more accurately. Recent studies have shown that the TC:HDL ratio is an important clinical predictor of acute myocardial infarction, coronary heart disease, and cardiovascular morbidity and mortality. 

How can I better understand my total cholesterol:HDL ratio?

To better interpret your results, here are some values to refer to:

• High risk: > 6
• Moderate risk: 4.5 – 6
• Low risk: < 4.5
• Very good: < 3.5

How can I maintain an optimal TC:HDL ratio?

For more information on how to improve your TC:HDL ratio, please refer to the Total Cholesterol and/or HDL-C biomarker pages. Additionally, you may also find the LDL-C and Triglycerides pages helpful.

Where can I learn more?

• University of Rochester Medical Center – Lipid Panel with Total Cholesterol:HDL
• Cleveland Clinic – Cholesterol Numbers and What They Mean