Cholesterol levels: What numbers should you aim for?

Figuring out the best cholesterol levels to aim for can be confusing. But here's some help setting your cholesterol number targets.

By Mayo Clinic staff

It's important to keep your cholesterol levels within healthy limits. And if you have other risk factors for developing heart disease, you need to be even more careful — especially with your low-density lipoprotein (LDL), or "bad," cholesterol level.

Interpreting your cholesterol numbers

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood in the United States and some other countries. Canada and most European countries measure cholesterol in millimoles (mmol) per liter (L) of blood. Consider these general guidelines when you get your cholesterol test (lipid panel or lipid profile) results back to see if your cholesterol falls in an ideal range.

Total cholesterol
U.S. and some other countries	Canada and most of Europe
Below 200 mg/dL	Below 5.2 mmol/L	Desirable
200-239 mg/dL	5.2-6.2 mmol/L	Borderline high
240 mg/dL and above	Above 6.2 mmol/L	High

LDL cholesterol
U.S. and some other countries	Canada and most of Europe
Below 70 mg/dL	Below 1.8 mmol/L	Ideal for people at very high risk of heart disease
Below 100 mg/dL	Below 2.6 mmol/L	Ideal for people at risk of heart disease
100-129 mg/dL	2.6-3.3 mmol/L	Near ideal
130-159 mg/dL	3.4-4.1 mmol/L	Borderline high
160-189 mg/dL	4.1-4.9 mmol/L	High
190 mg/dL and above	Above 4.9 mmol/L	Very high

HDL cholesterol
U.S. and some other countries	Canada and most of Europe
Below 40 mg/dL (men) Below 50 mg/dL (women)	Below 1 mmol/L (men) Below 1.3 mmol/L (women)	Poor
50-59 mg/dL	1.3-1.5 mmol/L	Better
60 mg/dL and above	Above 1.5 mmol/L	Best

Triglycerides
U.S. and some other countries	Canada and most of Europe
Below 150 mg/dL	Below 1.7 mmol/L	Desirable
150-199 mg/dL	1.7-2.2 mmol/L	Borderline high
200-499 mg/dL	2.3-5.6 mmol/L	High
500 mg/dL and above	Above 5.6 mmol/L	Very high

The American Heart Association (AHA) recommends that a triglyceride level of 100 mg/dL (1.3 mmol/L) or lower is considered "optimal." The AHA says this optimal level would improve your heart health. However, the AHA doesn't recommend drug treatment to reach this level. Instead, for those trying to lower their triglycerides to this level, lifestyle changes such as diet, weight loss and physical activity are encouraged. That's because triglycerides usually respond well to dietary and lifestyle changes.

*Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.

LDL targets differ

Because LDL cholesterol is a major risk factor for heart disease, it's the main focus of cholesterol-lowering treatment. Your target LDL number can vary, depending on your underlying risk of heart disease.

Most people should aim for an LDL level below 130 mg/dL (3.4 mmol/L). If you have other risk factors for heart disease, your target LDL may be below 100 mg/dL (2.6 mmol/L). If you're at very high risk of heart disease, you may need to aim for an LDL level below 70 mg/dL (1.8 mmol/L). In general, the lower your LDL cholesterol level is, the better.

You're considered to be at a high risk of heart disease if you have:

• A previous heart attack or stroke
• Artery blockages in your neck (carotid artery disease)
• Artery blockages in your arms or legs (peripheral artery disease)

In addition, two or more of the following risk factors might also place you in the very high risk group:

• Smoking
• High blood pressure
• Low HDL cholesterol
• Diabetes
• Family history of early heart disease
• Age older than 45 if you're a man, or older than 55 if you're a woman
• Elevated lipoprotein (a), another type of fat (lipid) in your blood

Types of cholesterol

LDL cholesterol can build up on the inside of artery walls, contributing to artery blockages that can lead to heart attacks. Higher LDL cholesterol levels mean higher risk. High-density lipoprotein (HDL) cholesterol is known as "good" cholesterol because it helps prevent arteries from becoming clogged. Higher HDL cholesterol levels generally mean lower risk.

A blood test to check cholesterol levels — called a lipid panel or lipid profile — typically reports:

• Total cholesterol
• HDL cholesterol
• LDL cholesterol
• Triglycerides, a type of fat often increased by sweets and alcohol

For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.