You’ve done your blood test. The report arrives. It’s full of numbers, abbreviations, and reference ranges. But what do they actually mean? Understanding your cholesterol report is the first step in protecting your heart health.
The Key Numbers in a Cholesterol Report
1. Total Cholesterol
What it is: The overall amount of cholesterol in your blood.
Healthy range: Less than 200 mg/dL is desirable.
Why it matters: A first glance marker, but not the whole story.
2. LDL (Low-Density Lipoprotein) – The “Bad” Cholesterol
Healthy range: Less than 100 mg/dL is optimal.
Why it matters: High levels increase risk of heart disease by building plaque in arteries.
3. HDL (High-Density Lipoprotein) – The “Good” Cholesterol
Healthy range: 40 mg/dL or higher for men, 50 mg/dL or higher for women.
Why it matters: The higher the HDL, the more protection for your arteries.
4. Triglycerides
Healthy range: Less than 150 mg/dL.
Why it matters: High levels often go hand-in-hand with obesity, diabetes, or high sugar intake and can worsen heart risk.
The Importance of Cholesterol Ratios
While individual numbers are useful, ratios often give a clearer picture of overall heart risk.
1. Total Cholesterol to HDL Ratio
Formula: Total cholesterol ÷ HDL
Healthy target: Below 5, ideally around 3.5 or lower.
Meaning: A lower ratio means you have more “good” cholesterol to balance the “bad.”
2. LDL to HDL Ratio
Formula: LDL ÷ HDL
Healthy target: Below 3.5.
Meaning: If your LDL is high but your HDL is also high, the risk is less severe than having high LDL with low HDL.
3. Triglyceride to HDL Ratio (emerging marker)
Formula: Triglycerides ÷ HDL
Healthy target: Below 2 (in mg/dL).
Meaning: A higher ratio may signal insulin resistance or metabolic syndrome, both strong risk factors for heart disease.
In simple terms:
High HDL improves your ratios, even if total cholesterol is a bit high.
Low HDL worsens your ratios, even if LDL isn’t sky-high.
Ratios tell you whether the balance of cholesterol in your blood is protective or risky.
Putting It All Together
Think of your cholesterol report like a financial statement:
LDL is like debt—you want it low.
HDL is like savings—you want it high.
Triglycerides are like spending—you should keep them modest.
Ratios are like your net worth—they show the real balance between risk and protection.
A Story to Remember
A 45-year-old man once shared how his total cholesterol was slightly above 200 mg/dL, and he was anxious. But when his doctor calculated his ratios, his total/HDL ratio was 3.2—well within the safe zone because his HDL was high. Instead of medication, the doctor encouraged him to maintain exercise and a healthy diet. His story shows why ratios are often more meaningful than just chasing one number.
Takeaway
Don’t just focus on a single number in your cholesterol report. Look at the full picture—LDL, HDL, triglycerides, and especially the ratios. They reveal whether your cholesterol is working against you or protecting you.
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Dr. Alfred D'Silva 
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