High-density lipoprotein (HDL) is a healthy type of cholesterol. Non-HDL cholesterol refers to the sum of all the unhealthy types of cholesterol, which can contribute to plaque accumulation in the blood vessels.

Healthcare professionals calculate non-HDL cholesterol by subtracting HDL cholesterol from total cholesterol.

The treatment for any type of high cholesterol can involve lifestyle changes such as eating a diet low in saturated fat, exercising regularly, and stopping smoking, if applicable. Doctors may also prescribe medications, such as statins and cholesterol-lowering drugs.

Read more to learn about what non-HDL cholesterol is, what levels are normal, how to manage it, and more.

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HDL cholesterol, also known as “good” cholesterol, helps remove “bad” cholesterol from the blood vessels.

All the other types of cholesterol other than HDL are harmful, as they contribute to the accumulation of plaque in the blood vessels. This can obstruct blood flow, which increases the risk of heart attack and stroke.

Non-HDL cholesterol is the sum of cholesterols other than HDL. These includeTrusted Source:

  • Very low-density lipoproteins (VLDL): The liver produces these triglyceride-rich particles.
  • Intermediate density lipoproteins (IDL): These cholesterol-containing particles form when fat and muscle tissue remove triglycerides from VLDL.
  • Low-density lipoproteins (LDL): These particles come from VLDL and IDL. They account for most of the cholesterol in the body.
  • Lipoprotein (a), or Lp (a): Lp (a) is a specific type of LDL particle. It represents an increased genetic risk for atherosclerotic disease, which narrows blood vessels.
  • Chylomicrons: Cells of the intestinal lining make these particles to transport triglycerides and cholesterol to the liver and peripheral tissues. These particles are larger after eating a high fat meal.

If a person has high non-HDL cholesterol levels, they may have an increased risk of heart disease.

A 2023 review of past research concludes that non-HDL cholesterol levels are a consistent and reliable predictor of artherosclerotic cardiovascular disease (ACVD), which occurs when blood vessels become narrowed or blocked.

A person’s baseline non-HDL cholesterol below the age of 45 can predict the risk of cardiovascular events, such as a heart attack, later in life.

The chart below shows typical and high non-HDL levels:

Non-HDL cholesterolLevel
typicalless than 130 mg/dl
highmore than 130 mg/dl

Although levels lower than 130 mg/dl may indicate a typical non-HDL level, doctors may set a person’s target levels lower depending on their risk and prior medical history.

For example, those with a history of heart attacks may have a much lower target in order to reduce the risk of future problems more aggressively.

A 2023 review notes that past guidelines have recommended a non-HDL goal of 30 mg/dl higher than the goal for LDL.

For example, if a person is aiming for LDL levels of less than 70 mg/dl, their goal for non-HDL should be less than 100 mg/dl. However, some researchers question this approach.

High cholesterol usually does not produce symptoms. Many people with the condition remain unaware until they have a check-up or a cardiac event. This is why healthcare professionals usually check cholesterol levels annually in those over 65.

Doctors use a blood test to diagnose the condition, which measures:

  • LDL
  • HDL
  • triglycerides
  • total cholesterol

Based on these results, a doctor can calculate non-HDL. If it exceeds 130 mg/dl in an adult aged 20 or over, they have high levels.

Treating high cholesterol involves lifestyle adjustments and medication.

Lifestyle adjustments

Adopting a healthy lifestyle is part of any treatment of high cholesterol. A person may need to make various modifications, includingTrusted Source:

  • Eating heart-healthy foods: This involves limiting foods high in saturated fat and eating nutritious foods, such as fruits, vegetables, and whole grains.
  • Engaging in regular exercise: Research indicates that this increases HDL while lowering LDL and triglycerides.
  • Managing stress: Long-term stress can reduce HDL and raise LDL.
  • Reaching or maintaining a moderate weight: If a person has excess weight, lowering body fat can increase HDL and lower LDL.
  • Quitting smoking, if applicable: According to a 2020 review, smoking plays a key role in the processes that cause ACVD. Stopping can significantly reduce the risk of death.
  • Limiting alcohol consumption: A 2020 review notes there is strong evidence that heavy alcohol consumption increases the risk of cardiovascular disease.
  • Getting enough sleep: This helps repair and heal the heart and blood vessels.

Medications

Statins are the most commonTrusted Source class of medications for the treatment of high cholesterol. If statins are not suitable or not proving effective enough, doctors may prescribe other types of drugs, too, such as:

  • fibrates
  • PCSK9 inhibitors, such as inclisiran
  • bempedoic acid
  • ezetimibe

Non-HDL cholesterol denotes the total amount of harmful cholesterol in a person’s body. A typical level for people aged 20 years and older is less than 130 mg/dl.

People can often manage high cholesterol with healthy practices, such as eating a nutritious diet, exercising regularly, and maintaining a moderate weight. Additional treatment may involve statins and other cholesterol-lowering medications.