Summary: Facts about cholesterol ratio and its reliability as basis for diagnosis.

Is cholesterol ratio different from your cholesterol numbers? How significant is this in the diagnosis and treatment of possible heart disease?

Cholesterol ratio, instead of the total blood cholesterol, is used by some doctors and cholesterol technicians in diagnosing atherosclerosis, or the disorder characterized by the accumulation of cholesterol on the walls of the arteries. The cholesterol ratio is derived by dividing the total cholesterol by the HDL cholesterol. So if a patient has a total cholesterol of 200 and an HDL of 50, his cholesterol ratio would be 4:1. The average ratio would be 4.5:1 or below 5:1, and the most ideal cholesterol ratio would be about 2:1 or 3:1 or anything under 4:1. This means that a high cholesterol ratio indicates a high risk for heart disease and a low cholesterol ratio is a lesser risk factor.

One other cholesterol ratio is the LDL/HDL ratio. This is considered as a more accurate because it is derived from the measurements of good cholesterol (HDL) and bad cholesterol (LDL). The measurement of the total blood cholesterol is not as accurate in the sense that the total blood cholesterol is the sum of other numbers like HDL, LDL, and other lipid components like the Triglycerides. The measure of total blood cholesterol includes HDL which is considered good cholesterol and does not pose as a cardiac risk. Thus, the total blood cholesterol measurement is not as good indicator of heart disease than the LDL/HDL cholesterol ratio.

So is it possible to have a high measurement for total blood cholesterol and a low LDL/HDL ratio?

It is definitely possible. A patient with a high absolute value for the total blood cholesterol can have a low LDL/HDL cholesterol ratio. This is best explained by looking at the compositions of the total blood cholesterol. It is merely derived from the measurements of the LDL, HDL, and Triglycerides. A high total blood cholesterol yet a low LDL/HDL cholesterol ratio would mean that the Triglycerides has contributed a lot. The triglycerides are the only ones unaccounted for in LDL/HDL cholesterol ratio. Therefore, the presence of the triglycerides in the blood makes the total blood cholesterol rise.

Even if the LDL/HDL cholesterol level is a reliable indicator of a risk for heart disease, the American Heart Association still suggest that the values obtained in the lipoprotein test for the total blood cholesterol and the HDL cholesterol level be used by doctors as basis for their diagnosis and treatment for patients.