For most healthy adults, total cholesterol should be under 200 mg/dL, LDL (“bad”) cholesterol under 100 mg/dL, HDL (“good”) cholesterol above 40 mg/dL, and triglycerides under 150 mg/dL. But these targets shift depending on your age, sex, and heart disease risk, so the full picture matters more than any single number.
LDL Cholesterol: The Number That Matters Most
LDL cholesterol is the one your doctor cares about most, because it’s the type that builds up inside artery walls and forms plaques that can lead to heart attacks and strokes. Here’s how the standard ranges break down:
- Below 100 mg/dL: Optimal
- 100 to 129 mg/dL: Near optimal
- 130 to 159 mg/dL: Borderline high
- 160 to 189 mg/dL: High
- 190 mg/dL and above: Very high
These ranges apply to otherwise healthy adults with no history of heart disease. If you’ve already had a heart attack, stroke, or have been diagnosed with cardiovascular disease, the target drops significantly. Current guidelines from the American Heart Association and American College of Cardiology recommend aiming for LDL below 70 mg/dL in that case. At that level, arterial plaques actually shrink and stabilize, reducing the chance of future events. For people at the very highest risk, European guidelines push even lower, to below 55 mg/dL.
If you have diabetes or multiple risk factors like high blood pressure combined with smoking, your doctor will likely want your LDL well below 100, even if you haven’t had a cardiac event yet.
HDL Cholesterol: Higher Is Better
HDL works in the opposite direction from LDL. It picks up excess cholesterol circulating in your blood and carries it back to the liver for disposal, which is why it’s called the “good” type. Unlike other cholesterol numbers, you want HDL to be high.
For men, an HDL below 40 mg/dL is considered a risk factor for heart disease. For women, the threshold is higher: below 50 mg/dL signals increased risk. An HDL of 60 mg/dL or above is considered protective. Regular aerobic exercise, maintaining a healthy weight, and not smoking are the most reliable ways to raise HDL. Alcohol in small amounts can raise it slightly, but the cardiovascular tradeoffs don’t make it a recommended strategy.
Triglycerides
Triglycerides aren’t cholesterol, but they show up on the same blood test and play a real role in cardiovascular risk. They’re the most common type of fat in your blood, and your body converts excess calories, sugar, and alcohol into triglycerides for storage.
- Below 150 mg/dL: Healthy
- 150 to 199 mg/dL: Borderline high
- 200 to 499 mg/dL: High
- 500 mg/dL and above: Very high
Very high triglycerides (above 500) raise the risk of pancreatitis, a painful and potentially dangerous inflammation of the pancreas. Triglycerides respond strongly to diet and lifestyle changes. Cutting back on refined carbohydrates, sugary drinks, and alcohol can drop them substantially within weeks.
Total Cholesterol and Non-HDL
Total cholesterol is the number most people remember from their results. A reading under 200 mg/dL is considered desirable, 200 to 239 is borderline high, and 240 or above is high. But total cholesterol alone doesn’t tell you much, because it lumps the helpful HDL together with the harmful LDL. Someone with a total cholesterol of 210 driven mostly by high HDL is in a very different situation than someone at 210 with high LDL and low HDL.
That’s why many doctors now pay closer attention to non-HDL cholesterol, which is simply your total cholesterol minus your HDL. This single number captures all the potentially harmful cholesterol types in one figure. The optimal non-HDL level for most people is under 130 mg/dL. If you have a history of heart disease, the target is lower. The updated 2026 ACC/AHA guidelines specifically expanded their focus beyond LDL alone to include triglyceride-rich particles, making non-HDL an increasingly important number on your results.
Cholesterol Targets for Children and Teens
Kids and teenagers have different thresholds. For anyone 19 or younger, healthy levels are:
- Total cholesterol: Below 170 mg/dL
- LDL: Below 110 mg/dL
- HDL: Above 45 mg/dL
- Non-HDL: Below 120 mg/dL
Pediatric screening is typically recommended once between ages 9 and 11, and again between 17 and 21. Medication is rarely considered in children unless LDL stays above 190 mg/dL after six months of diet and exercise changes, or above 160 mg/dL in a child with additional heart disease risk factors like a strong family history.
Do You Need to Fast Before Testing?
For years, the standard advice was to fast for 9 to 12 hours before a cholesterol blood draw. That’s changing. Research has shown that total cholesterol, LDL, and HDL levels vary little based on whether you’ve eaten. Nonfasting LDL is just as accurate at predicting long-term cardiovascular outcomes as fasting LDL. Triglycerides do rise temporarily after a meal, so if your triglycerides come back borderline on a non-fasting test, your doctor may ask you to retest while fasting for a more precise reading.
Many clinics now accept non-fasting samples for routine screening, which makes it easier to get tested without scheduling an early morning appointment.
How to Read Your Results in Context
The numbers on your lipid panel don’t exist in isolation. A person with an LDL of 115 and no other risk factors is in a completely different position than someone with the same LDL who also smokes, has high blood pressure, and a parent who had a heart attack at 50. Your doctor uses your full risk profile, not just individual numbers, to decide whether lifestyle changes alone are enough or whether medication should be part of the plan.
If your results are reported in mmol/L (common in Canada, the UK, and much of Europe), you can convert to the U.S. standard by multiplying by 38.67 for cholesterol values and 88.57 for triglycerides. Or simply ask your provider which local reference ranges apply to your results.
Cholesterol levels can shift meaningfully with changes in diet, exercise, weight, and sleep quality. A single test is a snapshot. If your numbers come back elevated for the first time, a retest in a few months after making adjustments gives a much clearer picture of where you actually stand.