How to Read Your Cholesterol Blood Test: HDL, LDL, Total Cholesterol and Triglycerides

Have you ever looked at your health screening report and wondered what HDL, LDL, total cholesterol, triglycerides and cholesterol ratio actually mean?

You may have heard that HDL is “good cholesterol” and LDL is “bad cholesterol”. But what happens when your total cholesterol is high while your good cholesterol is also high? And why does your cholesterol ratio matter?

Understanding these numbers can help you take better care of your heart health.

 

What Is a Cholesterol Blood Test?

A cholesterol blood test, also known as a lipid profile or lipid panel, measures different types of fats in your blood. It helps your doctor assess your risk of cardiovascular diseases, including heart attack and stroke. 

A typical lipid profile includes:

• Total cholesterol

• LDL cholesterol (bad cholesterol)

• HDL cholesterol (good cholesterol)

• Triglycerides

Each result provides different information, so it is important to interpret them together rather than focus on a single number.

 

1. LDL Cholesterol: The “Bad” Cholesterol

LDL stands for low-density lipoprotein. It carries cholesterol through your bloodstream. When LDL levels are too high, cholesterol can build up in artery walls, forming plaque that narrows the arteries and increases the risk of heart disease and stroke. 

In general, a lower LDL level is better. However, your ideal LDL target depends on your overall cardiovascular risk.

People with diabetes, established cardiovascular disease or other significant risk factors may need a lower LDL target than people at lower risk.

 

2. HDL Cholesterol: The “Good” Cholesterol

HDL stands for high-density lipoprotein. It helps carry excess cholesterol away from the bloodstream and tissues towards the liver, where it can be processed and removed.

HDL is often called “good cholesterol” because healthier HDL levels are generally associated with a lower risk of cardiovascular disease. 

However, a high HDL level does not automatically cancel out the risks associated with high LDL. Your doctor will consider your complete lipid profile and other health factors.

 

3. Total Cholesterol: What Does It Tell You?

Total cholesterol measures the overall amount of cholesterol in your blood. It includes cholesterol carried by different lipoproteins, including LDL and HDL.

For many healthy adults, a total cholesterol level below 5.0 mmol/L is commonly used as a general guide. However, total cholesterol alone cannot determine your cardiovascular risk.

For example, two people may have the same total cholesterol level but very different LDL and HDL levels. Their overall risk may therefore differ.

This is why looking at the individual components of your lipid profile is important. 

 

4. Triglycerides: Another Type of Blood Fat

Triglycerides are a type of fat that your body uses for energy. Extra calories, particularly from excess sugars and refined carbohydrates, can be converted into triglycerides and stored in fat cells.

High triglyceride levels may be associated with an increased risk of cardiovascular disease, particularly when combined with high LDL or low HDL.

A general guide for adults is:

• Below 1.7 mmol/L: Usually considered normal

• 1.7–2.2 mmol/L: Borderline high

• 2.3–5.6 mmol/L: High

• 5.7 mmol/L or above: Very high

These ranges are general guides and may vary by laboratory. Very high triglycerides can also increase the risk of acute pancreatitis, so medical assessment is important. 

 

5. What Can Cause Unhealthy Cholesterol Levels?

Cholesterol and triglyceride levels can be affected by several factors, including:

• Diet high in saturated or trans fats

• Excessive intake of sugary foods and refined carbohydrates

• Lack of physical activity

• Excess body weight

• Smoking

• Excessive alcohol consumption, particularly for triglycerides

• Diabetes or certain thyroid, kidney and liver conditions

• Genetics and family history

• Certain medications

Even people who maintain a healthy weight and diet may have high cholesterol because of genetic factors or underlying health conditions.

 

6. How Can You Improve Your Cholesterol Levels?

Healthy lifestyle habits can help improve your lipid profile and support long-term heart health.

• Eat more vegetables, fruits, whole grains, legumes and other fibre-rich foods.

• Choose healthier unsaturated fats, such as those found in nuts, seeds, fish and olive oil.

• Reduce saturated and trans fats.

• Limit sugary drinks, refined carbohydrates and excessive alcohol.

• Exercise regularly.

• Maintain a healthy weight.

• Avoid smoking.

• Take prescribed cholesterol medication as directed.

If your cholesterol remains high, your doctor may recommend medication based on your LDL level and overall cardiovascular risk.