Library
/
Heart & Vascular Health
/
LDL/HDL Ratio Testing

LDL/HDL Ratio Testing

January 21, 2026
Subscribe for updates
By clicking “Subscribe” you agree to our Terms and Privacy Policy.
Your content is on its way!
By clicking “Subscribe” you agree to our TOS and Privacy Policy.
Oops! Something went wrong while submitting the form.

Do I need a LDL/HDL Ratio test?

Worried about your heart health or family history of cardiovascular disease? Could your cholesterol balance be putting you at risk, and could a simple ratio test help reveal your true heart health picture?

Your LDL/HDL ratio shows the balance between "bad" and "good" cholesterol in your blood. This single number gives you a clearer view of cardiovascular risk than looking at cholesterol levels alone.

Testing your LDL/HDL ratio gives you an essential snapshot of your heart health, empowering you to personalize your nutrition, exercise, and lifestyle choices based on what your body actually needs. It's the first step toward protecting your heart and reducing your risk.

Book your test now
With Superpower, you have access to a comprehensive range of biomarker tests
Book a LDL/HDL Ratio Testing Test
Physician reviewed
CLIA-certified labs
HIPAA compliant

Get tested with Superpower

If you’ve been postponing blood testing for years or feel frustrated by doctor appointments and limited lab panels, you are not alone. Standard healthcare is often reactive, focusing on testing only after symptoms appear or leaving patients in the dark.

Superpower flips that approach. We give you full insight into your body with over 100 biomarkers, personalized action plans, long-term tracking, and answers to your questions, so you can stay ahead of any health issues.

With physician-reviewed results, CLIA-certified labs, and the option for at-home blood draws, Superpower is designed for people who want clarity, convenience, and real accountability - all in one place.

Key benefits of LDL/HDL Ratio testing

  • Shows your balance between "bad" and "good" cholesterol in one number.
  • Flags cardiovascular risk more precisely than LDL or HDL alone.
  • Guides decisions on statin therapy or lifestyle changes to protect your heart.
  • Tracks how well diet, exercise, or medication improves your cholesterol balance.
  • Explains symptoms like chest discomfort or family history of early heart disease.
  • Clarifies risk in metabolic syndrome, prediabetes, or inflammatory conditions.
  • Best interpreted with total cholesterol, triglycerides, and your clinical picture.

What is LDL/HDL Ratio?

The LDL/HDL ratio is a calculated comparison between two types of cholesterol carriers in your blood. LDL (low-density lipoprotein) transports cholesterol from your liver to tissues throughout your body, while HDL (high-density lipoprotein) carries excess cholesterol back to your liver for removal. This ratio is derived by dividing your LDL cholesterol level by your HDL cholesterol level.

A snapshot of cholesterol balance

The ratio reflects the balance between cholesterol delivery and cholesterol clearance in your circulation. A higher ratio suggests more cholesterol is being deposited into artery walls relative to what's being removed. A lower ratio indicates a more favorable balance, with efficient cholesterol cleanup.

Why the ratio matters for heart health

This single number captures the dynamic tension between two opposing processes. It helps assess cardiovascular risk by showing whether your cholesterol transport system favors buildup or removal. The ratio integrates information from both lipoproteins, offering a functional view of how your body manages cholesterol traffic rather than looking at each carrier in isolation.

Why is LDL/HDL Ratio important?

The LDL/HDL ratio distills your cholesterol profile into a single number that reflects the balance between particles that deposit cholesterol into artery walls and those that pull it away. It offers a snapshot of cardiovascular risk that goes beyond looking at LDL or HDL alone. A lower ratio signals that your body is efficiently clearing cholesterol, while a higher ratio suggests accumulation and inflammation in blood vessels.

When the ratio favors protection

Values below 2.0 generally indicate that HDL is doing its job well, escorting excess cholesterol back to the liver and keeping arterial linings cleaner. This balance supports healthy blood flow, reduces oxidative stress, and lowers the likelihood of plaque formation. Women often maintain lower ratios than men due to estrogen's favorable effect on HDL, though this advantage diminishes after menopause.

When the ratio signals risk

Ratios above 3.5 suggest that LDL particles are overwhelming the system's ability to clear cholesterol, promoting fatty deposits in coronary, carotid, and peripheral arteries. Over time, this imbalance accelerates atherosclerosis, raising the risk of heart attack, stroke, and vascular disease. Men and postmenopausal women are particularly vulnerable to higher ratios.

The bigger cardiovascular picture

This ratio integrates with other metabolic signals like triglycerides, blood sugar, and inflammation markers to reveal how well your body manages lipid traffic. It reflects not just cholesterol transport but also insulin sensitivity, liver function, and systemic inflammation, making it a powerful window into long-term heart and metabolic health.

What do my LDL/HDL Ratio results mean?

Low LDL/HDL ratio values

Low values usually reflect a favorable balance between atherogenic and protective cholesterol particles. This pattern suggests efficient reverse cholesterol transport, where HDL is effectively removing cholesterol from arterial walls relative to the amount being deposited by LDL. A low ratio typically indicates lower cardiovascular risk at the lipid level, though it must be interpreted alongside absolute LDL and HDL concentrations.

Optimal LDL/HDL ratio values

Being in range suggests a balanced lipid profile with moderate cardiovascular risk. Most guidelines consider a ratio below 3.5 desirable, with values closer to 2.0 or lower reflecting better metabolic and vascular health. The optimal ratio tends toward the lower end of the reference range, as this indicates proportionally more HDL relative to LDL.

High LDL/HDL ratio values

High values usually reflect an imbalance favoring atherogenic particles over protective ones. This pattern suggests either excessive LDL production or retention, insufficient HDL-mediated cholesterol clearance, or both. Elevated ratios are commonly seen with insulin resistance, metabolic syndrome, chronic inflammation, and diets high in refined carbohydrates or saturated fats.

Factors that influence LDL/HDL ratio interpretation

The ratio can shift with hormonal changes, including menopause and pregnancy. Acute illness, medications like corticosteroids or certain beta blockers, and genetic lipid disorders also influence results. Interpretation is most meaningful when paired with absolute lipid values and clinical context.

Method: Derived from FDA-cleared laboratory results. This ratio/index is not an FDA-cleared test. It aids clinician-directed risk assessment and monitoring and is not a stand-alone diagnosis.

Subscribe for updates
By clicking “Subscribe” you agree to our Terms and Privacy Policy.
Your content is on its way!
By clicking “Subscribe” you agree to our TOS and Privacy Policy.
Oops! Something went wrong while submitting the form.

Similar biomarker tests from Superpower

See more biomarkers

Frequently Asked Questions

Read more
How it works
What should I expect during a blood draw?
  • A trained phlebotomist will guide you through the process.
  • A tourniquet is placed on your arm, the site is cleaned, and a small needle is used to collect blood into one or more tubes.
  • Results are usually ready in about a week.
  • Most people feel only a quick pinch.
  • The needle is removed, gentle pressure is applied, and a bandage is placed.
How do I prepare for a blood draw?
  • Drink plenty of water beforehand — hydration makes veins easier to find.
  • Wear loose sleeves so your arm is easy to access.
  • Follow any fasting instructions you’ve been given.
  • Let us know if you’re on medications, have fainted before, or have needle anxiety.
What should I do after my blood draw?
  • Press gently on the site for a few minutes.
  • Keep the bandage on for 4-6 hours.
  • Skip heavy lifting or strenuous exercise for the rest of the day.
  • Drink extra water to rehydrate.
  • Monitor the site for redness, swelling, or pain.
How do I book a blood draw with Superpower?

Your membership includes:

  • An annual full body test and report across 100+ biomarkers
  • A personalized action plan to optimize your biomarkers and reach your health goals
  • A dashboard to centralize your health data and track changes across a lifetime
  • Access to a health concierge for questions on your plan and help scheduling
  • Plus a marketplace of curated health products and services cheaper than amazon

Many concierge clinics charge $10k – $100k for their services, we’ve built technology to make the world’s best healthcare as accessible as possible via an all-in-one membership.

Where can I take my blood test?

Superpower is currently available in the following US states:

  • Alabama
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Idaho
  • Illinois
  • Indiana
  • Kansas
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • South Carolina
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
Our testing
Does Superpower replace my primary care provider?

Superpower specializes in prevention-based testing and treatments and is not intended for emergency or immediate health issues.

While you will have a Superpower care team, your annual membership is designed to complement a primary care doctor if you have one, not replace them.

We are happy to help you share any test results with an outside provider to ensure you receive well-rounded medical care.

How fast are blood test results and how do I read them?

Your annual lab test panel takes about a week to process. We will text you as soon as they become available in your dashboard. Other types of tests may have different testing windows. The Superpower concierge is your own health assistant who helps answer your questions on your results, ensure smooth scheduling, coordination of any office-based tests, specialist referrals as needed, and navigating you to interface with your care team.

Does Superpower accept health insurance?

Superpower membership and products are all eligible for HSA/FSA funding.

We see Superpower like a gym membership for those committed to prevention and performance. Superpower is a bridge between wellness and healthcare. Health insurance traditionally focuses on reactive care whereas, at Superpower, we believe it’s never too early to start looking out for your long-term health.

What if I want more than 1 blood test per year?

Absolutely — you're not limited to just one. Your membership includes one comprehensive 100+ biomarker blood test each year, but if you'd like to track your progress more closely, you can add extra tests at any time. Each additional full-panel test costs $179. You can order as many as you'd like throughout the year.

“Best health check of my entire life.”

Vinay Hiremath, Founder of Loom

“Life changing”

Jordi Hayes, Founder of Capital.xyz

Frequently Asked Questions about LDL/HDL Ratio Testing

What is the LDL/HDL ratio blood test and what does it measure?

The LDL/HDL ratio compares low-density lipoprotein (LDL) to high-density lipoprotein (HDL) to show your balance between “harmful” cholesterol delivery and “protective” cholesterol removal. LDL carries cholesterol from the liver into tissues and artery walls, while HDL helps collect excess cholesterol and transport it back to the liver for clearance. The ratio provides a single snapshot of cholesterol traffic and cardiovascular risk beyond LDL or HDL alone.

Why is the LDL/HDL ratio important for heart disease and stroke risk?

The LDL/HDL ratio matters because it reflects the net balance between plaque-forming cholesterol deposition (LDL) and cholesterol cleanup (HDL). A higher ratio suggests cholesterol is being deposited faster than it’s cleared, which can accelerate atherosclerosis and inflammation. A lower ratio indicates more efficient reverse cholesterol transport and cleaner arteries over time. This makes the ratio a helpful indicator of long-term cardiovascular risk and metabolic health.

What is considered a good or optimal LDL/HDL ratio range?

In general, values below 3.5 are considered desirable in many clinical contexts, with ratios closer to 2.0 or lower reflecting a more favorable balance. A ratio below about 2.0 often suggests HDL is doing a strong job of clearing cholesterol and is associated with lower inflammation and better insulin sensitivity. Interpretation should still consider your full lipid panel and cardiovascular history rather than relying on a single number.

What does a high LDL/HDL ratio mean and what can cause it?

A high LDL/HDL ratio usually means LDL is high, HDL is low, or both - shifting the body toward cholesterol deposition and higher cardiovascular risk. Ratios above about 3.5 suggest LDL may be overwhelming HDL’s protective capacity, increasing risk for plaque buildup, arterial stiffness, and reduced blood flow. Common drivers include insulin resistance, metabolic syndrome, chronic inflammation, sedentary habits, chronic stress, low thyroid function, and diets high in refined carbohydrates and trans fats.

What does a low LDL/HDL ratio mean, and can it ever be concerning?

A low LDL/HDL ratio typically indicates a favorable lipid balance with proportionally higher HDL relative to LDL, suggesting reduced cardiovascular risk at the lipid-transport level. Ratios below about 2.0 are generally considered protective and linked with healthier arteries. However, extremely low total cholesterol (not just a low ratio) may warrant checking factors like liver function or nutrient absorption, especially if symptoms or other labs suggest an issue.

How is the LDL/HDL ratio better than looking at LDL or HDL alone?

The ratio combines both sides of cholesterol transport - LDL delivery into tissues and HDL removal back to the liver - into one metric. This can flag cardiovascular risk more accurately than LDL or HDL in isolation, especially when values are borderline. It helps clarify whether “not that bad” LDL or “pretty good” HDL actually translates to a balanced cholesterol traffic pattern. It’s best used alongside total cholesterol, triglycerides, and overall cardiovascular history.

How do diet and exercise change the LDL/HDL ratio over time?

Diet and exercise can improve the LDL/HDL ratio by lowering LDL, raising HDL, or both, shifting the balance toward cholesterol clearance. The ratio is useful for tracking how well lifestyle changes are working, not just whether one number moved slightly. Because a high ratio is often linked with refined carbohydrates, trans fats, and insulin resistance, improving food quality and activity can support better lipid metabolism and reduced inflammation over time.

When should I consider statin therapy based on my LDL/HDL ratio?

The LDL/HDL ratio can help guide decisions about statin therapy because it reflects overall cholesterol balance and risk more than LDL alone. A higher ratio may indicate that LDL’s plaque-forming effect is outpacing HDL’s protective function, supporting more aggressive risk reduction. However, it should be interpreted with total cholesterol, triglycerides, and your cardiovascular history (including other risk factors), since medication decisions depend on overall risk, not a single ratio.

Why can my LDL/HDL ratio change with menopause, pregnancy, age, or illness?

Hormonal shifts and physiologic changes can alter LDL and HDL levels, which directly changes the LDL/HDL ratio. Women often have lower ratios than men due to higher baseline HDL, especially before menopause, and ratios may rise as hormones change. Age, body composition, inflammatory states, certain medications, and acute illness can temporarily move LDL and HDL up or down, affecting interpretation. For accuracy, consider retesting when stable and review trends over time.

If my total cholesterol is “normal,” why might my LDL/HDL ratio still be high?

Total cholesterol can look acceptable while the balance between LDL and HDL is unfavorable. The LDL/HDL ratio can reveal hidden risk by showing that LDL is relatively high compared with HDL - even if total cholesterol doesn’t appear alarming. This is especially relevant for borderline results, insulin resistance, metabolic syndrome, or chronic inflammation, where the ratio may better reflect plaque-building risk. For best context, interpret it with triglycerides and your cardiovascular history.

Finally, healthcare that looks at the whole you