A total cholesterol of 247 mg/dL is high. The CDC defines high total cholesterol as 240 mg/dL or more, and healthy adults should aim for less than 200 mg/dL. At 247, you’re 47 points above the healthy threshold, which puts you at increased risk for heart disease and stroke.
That said, total cholesterol is only part of the picture. What matters more is the breakdown behind that number, specifically how much of it comes from harmful versus protective cholesterol. A 247 reading is a clear signal to dig deeper, not necessarily a reason to panic.
Where 247 Falls on the Scale
For adults 20 and older, cholesterol levels break into three general zones. Below 200 mg/dL is considered healthy. The range between 200 and 239 is borderline high. And 240 or above is high. At 247, you’re in the high category, but just barely past the cutoff. For anyone 19 or younger, the healthy threshold is even lower: under 170 mg/dL.
These thresholds are the same for men and women. While hormonal differences can influence cholesterol patterns (women’s levels often rise after menopause, for instance), the definition of “high” doesn’t change based on sex.
Why Total Cholesterol Doesn’t Tell the Full Story
Many doctors now consider total cholesterol one of the less useful numbers on a lipid panel. The Mayo Clinic notes that non-HDL cholesterol, which is your total cholesterol minus your “good” HDL cholesterol, is a better predictor of heart disease risk than either total cholesterol or LDL alone. That’s because non-HDL cholesterol captures all the harmful types of cholesterol in a single number.
Here’s why this matters for a reading of 247: if your HDL is unusually high, say 80 or 90 mg/dL, your non-HDL number could still be reasonable. A high HDL pulls up the total without adding risk. On the other hand, if your HDL is low and your LDL is doing most of the heavy lifting, a total of 247 is more concerning. Your cholesterol ratio (total cholesterol divided by HDL) gives another useful snapshot. Higher ratios mean higher risk.
So when you get a result of 247, the first question to ask isn’t “how do I lower this?” It’s “what’s making up this number?” A standard lipid panel breaks it into LDL, HDL, and triglycerides, and those individual values shape what happens next far more than the total does.
How Doctors Decide on Treatment
Current guidelines from the American Heart Association and American College of Cardiology don’t treat cholesterol in isolation. Instead of reacting to a single number, doctors estimate your overall 10-year risk of a cardiovascular event using a calculator that factors in age, blood pressure, cholesterol levels, diabetes status, and other variables. Adults aged 30 to 79 without existing heart disease are sorted into risk categories: low (under 3%), borderline (3% to 5%), intermediate (5% to 10%), or high (10% or above).
Your risk category determines how aggressively cholesterol gets treated. Someone at low risk with a total of 247 might focus entirely on lifestyle changes. Someone at intermediate or high risk with the same number may benefit from medication to bring LDL down by 30% to 50% or more. If LDL is extremely high, at 190 mg/dL or above, that alone can warrant treatment regardless of other risk factors. People with diabetes between ages 40 and 75 are generally recommended for cholesterol-lowering treatment even if their estimated risk seems modest.
Tests That Give a Clearer Picture
If your total cholesterol came back at 247, a standard lipid panel is the starting point, but there are follow-up tests that can sharpen the picture. An advanced lipid panel measures a protein called apoB and counts your actual cholesterol particles, which gives more detail about risk than just measuring cholesterol concentration. The American Heart Association also recommends every adult get tested at least once for a lipoprotein called Lp(a), a genetically determined risk factor that standard panels miss entirely.
A coronary artery calcium scan is another option, particularly for men over 40 and women over 45. This imaging test looks for early plaque buildup in artery walls and is most helpful when it’s unclear whether starting medication makes sense. A high-sensitivity CRP blood test measures inflammation linked to heart attack and stroke risk, adding another data point to the decision. None of these tests are routine for everyone, but with a total cholesterol of 247, they can help distinguish between someone who needs aggressive treatment and someone who can take a more measured approach.
What Actually Lowers Cholesterol
Exercise has a meaningful, measurable effect on cholesterol. In a study published in the Journal of the American Heart Association, moderate-intensity aerobic exercise reduced LDL (“bad” cholesterol) by about 7% while raising HDL (“good” cholesterol) by nearly 7%. Stepping up to high-intensity exercise pushed HDL gains even further, to around 8% above moderate-exercise levels. These shifts also improved how efficiently the body clears cholesterol from blood vessels, a process that protects artery walls from plaque buildup.
Diet changes can move the needle as well. Reducing saturated fat, increasing soluble fiber (from foods like oats, beans, and lentils), and replacing animal fats with unsaturated fats from nuts, olive oil, and fish are the most consistently supported strategies. Losing excess weight, even a modest amount, tends to improve the entire lipid profile.
For people whose risk profile calls for it, medication can lower LDL far more dramatically than lifestyle changes alone, often by 30% to 50% or more. But for someone at 247 total cholesterol without other major risk factors, lifestyle changes are typically the first step, with retesting in a few months to see how much the numbers move. The goal isn’t necessarily to get total cholesterol under 200. It’s to get LDL, non-HDL, and your overall risk profile into a range where your arteries stay healthy long-term.