What is my cholesterol ratio?
Total to HDL and triglycerides to HDL from your panel, with your non-HDL beside them, the number the 2026 guideline sets a goal for.
Showing an example panel. Type your own numbers.
Leave LDL blank if your report says calculated.
ApoB, if your report has it
Both sets of changes apply. Start with triglycerides, since they move in weeks.
The ratios
From the same numbers- Total to HDL
- 5.7
- Triglycerides to HDL
- 6.3in mg/dL
The ratios have no goal in the 2026 guideline. Non-HDL does, and it uses the same two numbers.
LDL
The NIH equation, from your other three numbers134mg/dL, 3.5 mmol/L
The newer equation says 134, and many labs would print 129. A gap of 5 mg/dL.
Clears 0 of 3 goal lines. Compared with under 100, the goal at borderline or intermediate risk. Ask your doctor for your PREVENT score to find your rung.
Non-HDL
Total minus HDL: the cholesterol in every particle that can clog an artery177mg/dL, 4.6 mmol/L
Compared with under 130 mg/dL. Its goals sit 30 points above LDL's, and with triglycerides of 150 or more the guideline finds it the better guide.
Triglycerides
Not fasting240mg/dL, 2.7 mmol/L
Over the nonfasting line of 175, the guideline's line for treating triglycerides with lifestyle.
- HDL
- 38Low, under 40. Higher isn't a goal.
- Remnant, an estimate
- 43Total minus HDL minus LDL. Rises with triglycerides
- Total
- 215Under the NCHS line of 240, and the guideline sets no goal for it
You're 34 points from under 100, the goal at borderline or intermediate risk. The biggest single food change in trials takes off about 13. A gap this size is a conversation to have with your doctor.
Next step. Start with alcohol and sweet drinks for your triglycerides, add the fat swap and 10 g of psyllium for your LDL, then retest at the same lab in 6 to 12 weeks. The LDL plan
If you ate before this test, your LDL moved about 8 points at most, your triglycerides about 26.
What your result means
No 2026 goal uses a ratio, so a ratio alone can't tell you if you're on track. Look at your non-HDL beside it, which the guideline does set a goal for.
- A high total to HDL ratio usually means a high LDL, a low HDL or both. Your LDL and non-HDL against your goal tell you which one to work on.
- A high triglycerides to HDL ratio usually goes with high triglycerides. Alcohol, sweet drinks, weight and walking move both numbers, in weeks.
- Pushing HDL up to fix a ratio doesn't help. Drugs that raised HDL didn't prevent heart attacks.
The ratios and the goal
A ratio divides one number by another: total cholesterol by HDL, or triglycerides by HDL, both in mg/dL. The ratios have no goal in the 2026 guideline. Non-HDL does, and it uses the same two numbers, total minus HDL, so this page shows it beside them against the goal for your risk.
1 sources
- Blumenthal RS, Morris PB, Gaudino M and others, 2026 ACC/AHA guideline on the management of dyslipidemia, JACC, 2026doi.org
