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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 lipids, or fats. This panel measures:

  • Total cholesterol

  • HDL ("good") cholesterol

  • LDL ("bad") cholesterol

  • Triglycerides

Total cholesterol is a measurement of both good and bad cholesterol. LDL cholesterol moves cholesterol into your arteries, and 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 doctor can obtain 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 five years.

Why do I need this test?

You may have this test as part of your regular medical checkup. You may have this test done more often than every five 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 doctor may also order other tests to check for other coronary heart disease risk factors. These may include other blood tests or tests for diabetes and diseases of your thyroid, liver, or kidneys.

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your health care provider.

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.

In general:

  • The higher the ratio, the higher the risk.

  • Most doctors 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 requires a blood sample, which is drawn through a needle from a vein in your arm.

Does this test pose any risks?

Taking a blood sample with a needle carries risks that include bleeding, infection, bruising, or feeling dizzy. When the needle pricks your arm, you may feel a slight stinging sensation or pain. Afterward, the site may be slightly sore.

What might affect my test results?

Many factors can affect your results. These include medications, 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 nine to 12 hours before this test. Also let your doctor know if:

  • Your diet has changed significantly in the past week

  • You've been drinking alcohol in the last two days

  • You've had a heart attack in the last three months

In addition, be sure your doctor 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.