The published evidence is quite clear in documenting that the actual total cholesterol level is not the most critical risk factor for cardiovascular disease.
We need to be concerned about the ratio between the level of HDL-“good” cholesterol and total cholesterol.
Therefore, in adults, the HDL-“good” cholesterol/total cholesterol ratio should be higher than 0.24 (divide your HDL level by your cholesterol).
Or more precisely, the HDL/total cholesterol ratio:
- 0.24 or higher is considered ideal
- under 0.24 – low
- less than 0.10 – very dangerous.
Generally speaking, the higher the ratio, the better (, the lower your risk of a heart attack).
However, HDL is closely related to triglycerides.
It appears common for people with high triglycerides to have low HDL’s, and these same people also tend to have high levels of clotting factors in their bloodstream, which is unhealthy in protecting against heart disease.
Therefore, in adults, the triglyceride/HDL-“good” cholesterol ratio should be below 2 (divide your triglycerides level by your HDL).
Or more precisely, the triglyceride/HDL ratio:
- Two or less is considered ideal
- 4 – high
- 6 – much too high
And, since HDL (high-density lipoprotein) is protective against heart disease, the lower the ratio, the better.
In other words, the lower your triglycerides, or the higher your HDL, the smaller this ratio becomes.
It is now believed that the triglycerides/HDL ratio is one of the most potent predictors of heart disease.
A Harvard-lead study author reported:
“High triglycerides alone increased the risk of heart attack nearly three-fold.
And people with the highest ratio of triglycerides to HDL — the “good” cholesterol — had 16 times the risk of heart attack as those with the lowest percentage of triglycerides to HDL in the study of 340 heart attack patients and 340 of their healthy, identical age counterparts.
The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more, accurate than the LDL/HDL ratio (Circulation 1997;96:2520-2525).”