Understanding the HDL/LDL ratio in cholesterol levels

Atherosclerosis develops when cholesterol adheres to and thus damages the walls of the arteries. Many factors contribute to this process including diet, stress, smoking and lack of exercise. There are two types of cholesterol in the bloodstream. One type is called HDL, short for High-Density Lipoproteins. HDL is referred to as the “good” cholesterol because it clears out the arteries for smooth circulation.

The other type of cholesterol is LDL, or Low-Density Lipoproteins. LDL is the “bad” cholesterol because it sticks to the arterial walls and cannot be cleared out by the body’s usual methods. People have often looked at their cholesterol level (the combined total level of HDL and LDL) as an indication of cardiovascular health; however, we now know that cholesterol level does not tell the whole story.

You can have a high cholesterol level and not be at risk for heart disease, because what is important is the relationship of LDL and HDL to each other – not their combined total level. The more good HDL you have, and the less bad LDL you have, the better – and this is true even if the total cholesterol level seems high.

To figure out your HDL/LDL ratio, divide your total cholesterol level by your HDL level. A person with a ratio of 4.5 or higher (for example, a total cholesterol of 225 divided by HDL of 50) is twice as likely to have heart disease as a person whose ratio is 3.5 (225 divided by HDL of 64). Obviously, these two ratios are different even though the total cholesterol level, 225, is the same. For many years, cholesterol levels hovering around 220 would have been considered dangerous. However, if your total is 220 and your HDL is 55, your HDL/LDL ratio will be 4.0, which indicates generally good cardiovascular health. The more “good” HDL you have, the better your circulation. The less HDL you have, the more problematic circulation becomes.

In general, if your ratio is below 4.0, you are not at great risk for heart trouble. Measuring total cholesterol is not as informative as measuring the two separate types of cholesterol whose ratio to each other determines the risk factor for heart disease. May people with low total cholesterol levels have had heart attacks because their HDL levels were low.

On googlebooks.com. From Finding the Healer Within by Beth Moran and Kathy Schultz, © National League for Nursing Press, 1998, pages 129-130.