Normal range: 0 – 3 (lower is better)
The LDL/HDL ratio directly compares your harmful LDL particles to your protective HDL particles. Lower ratios indicate a more favorable lipid balance and lower cardiovascular risk. A ratio below 3.0 is generally considered good, while above 3.0 warrants attention. This ratio is particularly useful because two people with the same LDL can have very different risk profiles depending on their HDL.
LDL/HDL is calculated rather than ordered on its own, so it comes with a standard lipid panel (about $45). A fuller workup adds Vitamin D ($75), hs-CRP ($69), ApoB ($50), and ApoA1 ($50). You can test LDL/HDL and 100 other biomarkers for $190 as part of an Empirical membership.
Empirical is FSA/HSA eligible, so you can pay with pre-tax dollars. Fast for 8-12 hours beforehand for the most accurate lipid and metabolic results, and expect results in days rather than weeks.
The ratio of LDL cholesterol to HDL cholesterol is a strong predictor of heart disease risk. Lower ratios indicate lower risk.
LDL/HDL Ratio tends to fall with age (correlation with age, r = -0.09). The chart below shows the median by 5-year age bin and a linear trend line.
A normal LDL/HDL is 0 – 3. Lower is better.
A high LDL/HDL ratio is driven by the same factors that raise LDL (saturated fat, genetics, hypothyroidism) or lower HDL (inactivity, smoking, obesity). Addressing both sides simultaneously, through diet, exercise, and sometimes medication, is the most effective strategy.
Regular exercise is uniquely powerful here because it both lowers LDL and raises HDL, improving the ratio from both directions. Dietary changes (less saturated fat, more fiber and healthy fats) primarily address the LDL side. Statins lower LDL and provide a modest HDL increase.
LDL/HDL is most highly correlated with Apolipoprotein B and Non-HDL Cholesterol. Here are the top biomarkers correlated with LDL/HDL, based on 500,000 tests done by Empirical Health.
The percentage shows how strongly two biomarkers move together. A higher number means the relationship is stronger. Green = rises and falls together. Orange = one rises as the other falls.
LDL/HDL is drawn at 2,200+ Quest and BioReference patient service centers across the US, so there's usually one within a short drive. Browse the full directory to find the one closest to you.
Test your LDL/HDL Ratio and 100+ other biomarkers in a single blood draw.
