What should my LDL be?
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It depends on your risk. The 2026 US guideline sets an LDL goal under 100 mg/dL (2.6 mmol/L) at borderline or intermediate risk, under 70 (1.8) at high risk and under 55 (1.4) for most people who’ve had a heart attack or stroke. Non-HDL goals sit 30 points higher. At low risk there’s no number goal.
What we’d do
Ask your doctor for your 10-year risk from the PREVENT equations and write the number down next to your panel. If you don’t know it yet, hold your LDL against under 100, the goal for the biggest group of adults. If you’re over that, start the food changes now rather than waiting, since the guideline counts every year your LDL stays high. And at 190 or more, book a doctor visit whatever your risk.
If you remember three things
- Your goal follows your risk. The higher your chance of a heart attack or stroke, the lower the goal.
- Non-HDL gets a goal too. It’s 30 points above the LDL goal, and it works even when triglycerides are high.
- Lower kept working in the trials. In one large trial, risk kept falling even in people whose LDL went under 20.
Why isn’t there one healthy LDL?
A lab report prints one range beside LDL and leaves it there. That makes a 130 look a little high for everyone and a 95 look fine for everyone. But a 95 is far over the goal for someone with a stent, and a 130 in a 30 year old at low risk has no number goal at all in the guideline.
The 2026 guideline made goals by risk the center of the advice again. The American College of Cardiology’s announcement said it in one line: “LDL-C cholesterol and non-HDL-C goals are back in the new guideline.”
Like speed limits
A speed limit depends on the road. Outside a school it might be 20, on a highway 70, and nobody calls the highway limit the healthy speed. LDL goals work the same way. The more danger on your road, from a past heart attack, diabetes or a high 10-year risk, the lower your limit. Your lab report prints one sign for every road.
The 2026 goals
| Which fits you | LDL goal | Non-HDL goal |
|---|---|---|
| Heart attack, stroke, stent or bypass | under 55 mg/dL1.4 mmol/L, or under 70 (1.8) if your doctor says you're not at very high risk | under 85 mg/dL2.2 mmol/L, or under 100 (2.6) if your doctor says you're not at very high risk |
| Diabetes, ages 40 to 75 | under 100 mg/dL2.6 mmol/L, or under 70 (1.8) if your doctor puts your 10-year risk over 10% | under 130 mg/dL3.4 mmol/L, or under 100 (2.6) if your doctor puts your 10-year risk over 10% |
| High 10-year risk (10% or more) | under 70 mg/dL1.8 mmol/L | under 100 mg/dL2.6 mmol/L |
| Borderline or intermediate risk (3 to under 10%) | under 100 mg/dL2.6 mmol/L | under 130 mg/dL3.4 mmol/L |
| Low risk (under 3%) | No number goal, healthy habits | No number goal, healthy habits |
From the 2026 ACC/AHA guideline, with the low-risk and diabetes rows as Labcorp's summary sets them out. An LDL of 190 or more is a doctor visit at any risk.
Most people who’ve had a heart attack, stroke, stent or bypass are at very high risk in the guideline, which is where the goal of under 55 applies. Your cardiologist decides that, and the goal is under 70 if they don’t put you there.
Here’s an LDL of 134 on the ladder against the goal of under 100:
It clears none of the three goal lines. The biggest single food change in trials takes off about 13 points, so a gap of 34 usually needs two or three changes together, and a retest to see what they did. Is an LDL of 130 bad? walks through that case.
How your doctor works out your risk
For adults 30 to 79 without heart disease and with an LDL of 70 to 189, the guideline uses the PREVENT equations from the American Heart Association. They were built from about 3.3 million US adults and checked on another 3.3 million. They use your age, sex, blood pressure, total cholesterol, HDL, diabetes, smoking, kidney function and whether you take blood pressure or cholesterol medicine. Race isn’t in them, because it didn’t add anything to the prediction.
| Your 10-year risk | Band | LDL goal |
|---|---|---|
| Under 3% | Low | No number goal. Healthy habits |
| 3 to under 5% | Borderline | Under 100 |
| 5 to under 10% | Intermediate | Under 100 |
| 10% or more | High | Under 70 |
The older calculator, the pooled cohort equations, overestimated the 10-year risk of a heart attack and stroke by 40% to 50%, according to the guideline’s chair, so a risk you were told years ago may come out lower on PREVENT.
We don’t calculate your risk on this site, since it needs your blood pressure, kidney function and a doctor who knows your history. Blood pressure is one of the biggest inputs, and the blood pressure checker sorts yours in a minute.
What else moves your goal
A coronary calcium scan. For men 40 and older and women 45 and older at borderline or intermediate risk, a CT scan of the heart arteries can settle an unclear risk. Any calcium supports an LDL goal under 100. A score of 300 to 999 supports under 70, and 1,000 or more under 55.
Things that raise risk. The guideline’s list of risk enhancers, which can tip a borderline decision toward treatment, includes:
- A parent, brother or sister with heart disease young (men before 55, women before 65)
- South Asian or Filipino ancestry
- Lupus, rheumatoid arthritis, advanced psoriasis or another long-term inflammatory disease
- An Lp(a) of 125 nmol/L (50 mg/dL) or more (what is Lp(a)?)
- Triglycerides that stay at 175 or more after meals, or 150 or more fasting
- An LDL that stays at 160 to 189, a non-HDL of 190 to 219, or an ApoB of 120 or more
- Menopause before 45, or preeclampsia, gestational diabetes or high blood pressure in pregnancy, or a preterm birth
Diabetes. Adults 40 to 75 with diabetes have a goal under 100, or under 70 if their 10-year risk is over 10%.
Is lower always better?
Down to levels most people never see, yes. Across 26 statin trials and about 170,000 people, each 39 mg/dL (1 mmol/L) lower LDL cut major heart and blood vessel events by about a fifth, and the researchers found no level below which the benefit stopped. The 2026 guideline adds a newer result: in a large trial of a PCSK9 drug, risk kept falling with lower LDL even in the 24% of people whose LDL went under 20 mg/dL. The guideline cites it where it lowers the goal for people at very high risk from under 70 to under 55.
The low-risk row is the other side of this. A young adult at low risk has no number goal, because the chance of a heart attack in the next 10 years is small. But the guideline still says a moderate statin is reasonable for adults 30 to 59 at low risk with an LDL of 160 to 189, to cut down the years of exposure. There’s more on that in why LDL is a lifetime number.
4 sources
- Blumenthal RS, Morris PB, Gaudino M and others, 2026 ACC/AHA guideline on the management of dyslipidemia, JACC and Circulation, 2026doi.org
- Labcorp, 2026 ACC/AHA dyslipidemia guideline update (the goals table by risk)labcorp.com
- American College of Cardiology, ACC/AHA issue updated guideline for managing lipids, cholesterol, press release, 13 March 2026acc.org
- Cholesterol Treatment Trialists' Collaboration, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials, Lancet, 2010pubmed.ncbi.nlm.nih.gov
