Understand your cholesterol test results

Use this page to understand your cholesterol and triglyceride results and see if they are in the healthy range.

When you have a cholesterol test, ask your healthcare professional to explain the results, so you don't have any unnecessary worry or confusion. 

It’s not just your total cholesterol that’s important, so your results will include different types of cholesterol. If you are only given your total cholesterol, ask for a break-down of the other numbers – it’s possible to have a healthy total cholesterol (TC) number but an unhealthy balance of the different types of cholesterol. 

Ask for a print out of your results if you are not able to speak to your GP, nurse or pharmacist. 

What should your results include?

You should be given your total cholesterol (TC),  HDL cholesterol (good cholesterol), non-HDL cholesterol (sum of all the bad cholesterol which mainly includes LDL cholesterol), LDL cholesterol and TC:HDL ratio.

You should also have your triglycerides tested.   Triglycerides are  important blood fats which are linked to heart disease and should be measured alongside cholesterol.

  • Total cholesterol
    This is sometimes written as 'serum cholesterol' or 'TC' and refers to your overall level of cholesterol.
  • Non-HDL cholesterol
    Your non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. It’s all the 'bad' cholesterol added together, which mainly includes  LDL cholesterol.  Ideally it should be as low as possible.  
  • HDL cholesterol
    Your HDL cholesterol ('good' cholesterol) helps clear the cholesterol out of your arteries, while your LDL cholesterol ('bad' cholesterol) can clog them up.   HDL cholesterol levels of up to 1.4mmol/L are thought to offer the best protection,  but our specialists believe that levels higher than this may not give you any additional benefit.
  • TC:HDL-C ratio
    The TC:HDL-C ratio is only required for the calculation of 10 year and lifetime risk assessment, using QRISK risk calculators.    It is important to note that this ratio should be interpreted with caution as it may be reassuringly normal due to a high HDL cholesterol, even though someone has a high non-HDL cholesterol and LDL cholesterol.   
  • Non-HDL cholesterol is the current treatment target for primary prevention (for those who do not have cardiovascular disease) and there are specific targets for both non-HDL cholesterol and LDL cholesterol for those who have cardiovascular disease, (known as secondary prevention)

What is a healthy cholesterol level?

This table is a general guide for cholesterol and triglyceride levels for healthy adults in the UK.   If you are at higher risk of cardiovascular disease (CVD) or if you already have CVD (coronary heart disease, heart attack stroke etc) then your healthcare professional will discuss specific cholesterol lowering targets with you, based on current national guidelines.

  mmol/L mg/dL
Total (serum) cholesterol below 5.0 below 193
Non-HDL cholesterol below 4.0 below 155
LDL cholesterol below 3.0 below 116

HDL cholesterol

 

above 1.0 for a man

above 1.2 for a woman

(ideally around 1.4.  Very high levels may not give extra protection)

above 39 for a man

above 46 for a woman

     

 

What do your triglyceride results mean? 

Triglycerides are another type of blood fat and your triglyceride levels can tell you more about your health. If your triglycerides are high, it can mean you’re at risk of heart disease, liver disease and diabetes. 

You should have your triglycerides tested when you have a cholesterol test. 

What can raise your triglycerides?

Raised triglycerides and low HDL cholesterol

People with high triglyceride levels often have a low HDL level as well, which is an unhealthy combination that's often linked with premature heart disease. It can be inherited and often occurs in people who carry their weight around their middle

 

What is a healthy triglyceride level?

As a general rule, these are the ideal triglyceride levels for healthy adults. Fasting triglycerides are where you fast for a period of time before your blood test, usually 10-14 hours.

Fasting triglyceride below 1.7mmol/L below 150mg/dL
Non-fasting triglyceride below 2.3mmol/L below 204mg/dL

Converting from mmol/l to mg/dl

In the UK, cholesterol levels are measured in millimoles per litre (mmol/l). If you have your cholesterol tested in Europe or the US, they will be measured in milligrams per deciliter (mg/dl). Here’s how to convert from one to the other:

To convert cholesterol levels:
Cholesterol mg/dl = mmol/l x 38.6
Cholesterol mmol/l = mg/dl ÷ 38.6

To convert triglyceride levels:
Triglyceride mg/dl = mmol/l x 88.5
Triglyceride mmol/l = mg/dl ÷ 88.5

Cholesterol levels for men and women

HDL levels differ for men and women

Women naturally have higher HDL cholesterol (good cholesterol) levels than men due to differences in the genes. Women should aim for an HDL cholesterol level above 1.2mmol/L while men should aim for above 1mmol/L.

Cholesterol levels can rise during pregnancy

During pregnancy, both cholesterol and triglyceride levels can significantly rise. We don't recommend getting a cholesterol test during pregnancy because your results won't be accurate. Our advice is to wait until at least 6-8 weeks after your baby is born or after you stop breastfeeding to get a cholesterol test. This means you don't need to worry unnecessarily.

Cholesterol levels rise during the menopause

Women may also find their cholesterol levels rise during the menopause

Do you need to lower your cholesterol and triglycerides?

If you have high cholesterol, high triglycerides or an unhealthy balance of blood fats, your doctor will probably recommend bringing these levels down with lifestyle changes and sometimes treatments.

Your doctor should look at your results in relation to any other risk factors for heart disease such as high blood pressure, being overweight, smoking, and other health conditions such as diabetes.

If you are at higher risk or already have cardiovascular disease, i.e. heart attack, stroke or TIA, or have peripheral arterial disease, you should already be on cholesterol-lowering medication such as statins.  There are now specific targets to achieve for non-HDL cholesterol (below 2.6mmol/L) and LDL-cholesterol (below 2mmol/L)  with a lower the better approach.  

For primary prevention, i.e. for those who do not have CVD but are at higher risk,  national guidelines recommend reducing your non-HDL cholesterol  by more than 40%.

 

Find out your heart age with the Heart Age Tool

In addition to measuring your cholesterol and triglyceride levels, your healthcare professional should also work out your risk of developing heart disease and stroke over the next 10 years using a risk assessment calculator known as QRISK3.  This is given as a percentage and takes into consideration all risk factors that can contribute, not just cholesterol and triglycerides.  This forms part of the NHS Health check for those aged 40 - 74 in England.

Your healthcare professional can also work out your longer term risk using QRISK Lifetime calculator.  

These risk assessment tools are only for those who do not have existing heart disease and stroke, or high risk conditions.  

You  can also work out your own risk of developing heart disease over the next 10 years with the NHS Heart Age Tool.   You will get a more accurate result if you know your blood pressure numbers too.

The heart age tool is designed for people aged 25 to 84. It's not suitable for you if you already have a cardiovascular disease such as heart attack or stroke, or an inherited high cholesterol condition such as Familial Hypercholesterolaemia (FH). 



Page updated 2nd December 2024

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