Although the ratio of total cholesterol to HDL has some value, I don't use it any more in assessing risk factors for coronary heart disease and atherosclerosis. The number that I previously used as a target was 3.0, with a lower number representing a lower risk. A person can have a good ratio with a high total cholesterol when the HDL (good) cholesterol is high. The converse is true for a very low HDL.
The absolute values for LDL cholesterol and HDL cholesterol are more reliable guides for determining intensity of treatment. An HDL level of less than 40 milligrams per deciliter is low, and less than 30 mg/dL is very low. Goals for LDL cholesterol level depend upon presence or absence of other risk factors. If someone has coronary heart disease, or multiple other risk factors for coronary heart disease, or diabetes, the goal for LDL cholesterol is less than 100 milligrams per deciliter. Without additional risk factors, a high LDL with an HDL greater than 60 would be less worrisome and, if calculated, usually show a low ratio.
