Why does cholesterol HDL ratio matter?

The cholesterol HDL ratio is often used as an important indicator of heart disease risk. This ratio compares your total cholesterol to your “good” HDL cholesterol. Because HDL carries cholesterol away from the arteries, a higher level of HDL compared to total cholesterol implies a lower heart disease risk.

Cholesterol is a fatty substance that plays a very important role in your body. It has many functions that improve body functions. For example, it helps form cell membranes, produces hormones and helps in the production of vitamin D. 

Cholesterols are stored in different forms in your body like high density lipoprotein, low density lipoprotein and triglycerides.

All cholesterol forms aren’t in the same proportion. Having the right balance between the different types is important for heart health. One way to assess this balance is by looking at the cholesterol HDL ratio.

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What is the cholesterol HDL ratio?

The cholesterol HDL ratio, also referred to as the HDL ratio. It’s a measure of cardiovascular risks. It’s calculated by dividing your total cholesterol by your HDL (high-density lipoprotein) cholesterol levels.  

A lower ratio indicates healthier cholesterol levels and a lower risk for heart disease, while a higher ratio suggests a greater risk of atherosclerosis and ischemic heart disease (IHD).

Some studies agree that the ratio of total cholesterol (TC) and HDL-C (TC/HDL-C) is a more  efficient predictor of heart diseases like ischemic heart disease than only total cholesterol because it reveals more information.

However, doctors use the cholesterol HDL ratio alongside absolute cholesterol numbers to get a clearer picture of cardiovascular risk.

Normal and Abnormal Ranges

Cholesterol HDL has recommended ranges which are referred to as normal. Ranges outside these values are called abnormal. The ranges are 

Optimal: Less than 3.5

Borderline: 3.5 – 5.0

High risk: Greater than 5.0

What do the different ratios indicate?

Low ratios mean a greater proportion of HDL cholesterol, which has a protective effect against heart disease. High ratios suggest that LDL and total cholesterol outweigh the protective HDL, leading to increased risk of arterial plaque buildup and cardiovascular disease.

What is the Non-HDL cholesterol ratio?

Non-HDL cholesterol refers to all cholesterol types except HDL. It includes

• Low-density lipoproteins (LDL) 
• Very low-density lipoproteins (VLDL) 
• Intermediate-density lipoprotein (IDL) 
• Lipoprotein(a).

The Non-HDL Cholesterol ratio measures the "bad" cholesterol in your blood by subtracting your "good" High-Density Lipoprotein (HDL) cholesterol from your total cholesterol.

Non-HDL = Total cholesterol - HDL

A higher non-HDL cholesterol level means more "bad" cholesterol, which increases your risk of heart disease. A lower non-HDL level is healthier.

What is the LDL/HDL ratio?

The LDL/HDL ratio compares harmful LDL cholesterol with protective HDL cholesterol.

In a study, the findings showed that an elevated LDL/HDL ratio is consistently associated with increased atherosclerosis and coronary diseases.

Factors Affecting HDL Ratio

1. Diet

Replacing carbs with fats can raise good cholesterol (HDL) levels, although the best choice is unsaturated fats (olive oil, nuts, seeds, fish), not saturated fats. This is because too much saturated fat raises bad cholesterol (LDL). Also, added sugars decrease HDL levels. The best diet keeps saturated fat low, avoids trans fats, limits added sugar, and emphasizes unsaturated fats, omega-3s, and fiber.

2. Exercise

Regular physical activity raises HDL-C and lowers triglycerides. Conversely, lack of physical activity increases the risk of having unhealthy cholesterol levels (low HDL, high LDL and high triglycerides).

3. Stress 

Stress may raise levels of certain hormones, such as corticosteroids. These can cause your body to make more cholesterol. Also, acute mental stress can produce rapid elevations in serum cholesterol concentration, affecting HDL ratio.

4. Smoking

Smoking lowers HDL ratio, posing a risk for heart problems.

5. Alcohol

Moderate intake may increase HDL. In fact, a study showed that alcohol consumption has been associated with increased HDL-C (9.2%) independent of changes in other measured lipids. However, heavy drinking raises total cholesterol which might subsequently affect the ratio 

6. Sleep 

Sleep affects general health, including cardiovascular health. According to a study, short sleep durations in adolescent women could be a significant risk factor for high cholesterol.

7. Weight 

Obesity not only alters HDL levels but also alters HDL distribution patterns and causes abnormal HDL metabolism. This affects HDL cholesterol ratios. 

8. Family history

Family members usually have similar cholesterol levels. This suggests that your genes can raise your risk of having unhealthy cholesterol levels.

9. Medical Conditions

Conditions like diabetes, obesity, metabolic syndrome, thyroid disease, and liver disorders can worsen cholesterol ratios.

10. Genetics

Some people inherit disorders such as familial hypercholesterolemia. This causes very high LDL and poor HDL ratios despite healthy habits.

How to Improve Cholesterol HDL Ratio

• Eat heart-healthy foods such as the Mediterranean or Dietary Approach to Stop Hypertension Diet (DASH diet) which are foods rich in potassium, magnesium and calcium with less sodium, saturated fats and added sugar.
• Examples are vegetables, fruits, whole grains, lean meat, legumes, vegetable oils and low-fat dairy.
• Practice regular exercise (150 minutes of moderate aerobic activity weekly).
• Maintain a healthy weight to reduce LDL and improve HDL.
• Quit smoking.
• Limit your alcohol intake.
• Manage stress properly.
• Medical Interventions: medications may be prescribed if lifestyle changes are not enough.

Preventive Strategies 

Cholesterol imbalance causes serious cardiovascular events. It’s important to check your cholesterol levels regularly and make lifestyle adjustments. 

Summary 

Although cholesterol is very important for some bodily functions, deficiencies or excesses increase risk for cardiovascular disease. Knowing the various cholesterol value ratios helps to get better information regarding its effects in the body. With the adoption of heart-healthy choices i with coordination with your physician when necessary, you will bring positive balance to the cholesterol HDL hence significantly reducing the risk for cardiovascular disease.

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