LDL cholesterol
Also reported as: LDL-C · Low-density lipoprotein cholesterol · Bad cholesterol
The mass of cholesterol carried inside LDL particles — usually calculated from total cholesterol, HDL and triglycerides rather than measured directly.
Under 100 mg/dL is conventionally 'optimal' on a lab report; 100–129 'near optimal'.
Preventive-cardiology target for primary prevention in someone with additional risk factors. Guideline thresholds are risk-stratified rather than universal.
To convert to mmol/L, multiply by 0.02586.
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Where the thresholds sit
| Band | Range (mg/dL) | Note |
|---|---|---|
| Optimal | < 70 | — |
| Good | 70–100 | — |
| Near optimal | 100–130 | — |
| Borderline high | 130–160 | — |
| High | > 160 | — |
Why it matters
The longest-standing and best-evidenced modifiable cardiovascular risk factor. Mendelian randomisation and trial data agree that lowering it lowers events, and that lifetime exposure matters more than any single reading. Its weakness is that it measures cargo rather than particle count, which is where ApoB does better.
What raises it
- Saturated and trans fat intake
- Genetics, including familial hypercholesterolaemia
- Hypothyroidism
- Some ketogenic diets, in a subset of lean people
What lowers it
- Statins, ezetimibe, bempedoic acid, PCSK9 inhibitors
- Soluble fibre and plant sterols
- Replacing saturated fat with unsaturated fat
How to move it
- 1Ask for ApoB alongside it — where the two disagree, ApoB is the better guide.
- 2Reduce saturated fat before anything else.
- 3Add psyllium or oat beta-glucan daily.
- 4If calculated LDL-C is reported and triglycerides are above 400 mg/dL, the calculation is unreliable — ask for a direct measurement.
What moves this marker
Interventions on this site with evidence behind them for this specific marker. None of them replaces working out why yours is where it is.
What makes a single reading misleading
- Most panels calculate rather than measure LDL-C, and the Friedewald equation loses accuracy at high triglycerides or low LDL.
- Requires a 9–12 hour fast when calculated.
Sources
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Educational only. Reference ranges are not diagnostic thresholds and this page cannot account for your medical history, medication or symptoms. Discuss any result that concerns you with a qualified clinician. See our medical disclaimer.