Q: Why do you rarely mention the ratio of total cholesterol to HDL when you discuss blood cholesterol?
A: The individual levels of HDL (“good”) and LDL (“bad”) cholesterol are more important than the ratio. That’s why most experts, including the National Cholesterol Education Program, have de-emphasized the ratio. A ratio is simply a comparison of two numbers. If your total cholesterol is 200 and your HDL is 40, your ratio is 200/40, which equals 5.
The ratio of total cholesterol to HDL (or sometimes the ratio of LDL to HDL) may appear on your lab report when you have a full blood test for coronary risk. It is still a useful tool—more so than total cholesterol alone, since it does factor in your HDL level. According to the Framingham Heart Study, a ratio of 5 puts a man at average risk; 4.4 puts a woman at average risk. Ideally the number should be 3.5 or lower.
What you really need to know are your HDL and LDL levels. Your LDL should be below 130, and optimally below 100. HDL should be over 40 for a man, over 50 for a woman.