A person’s non-high-density lipoprotein (non-HDL) cholesterol level is the amount of potentially harmful cholesterol in their body. A doctor will work this out by subtracting a person’s HDL cholesterol level from their total cholesterol level.

If a person has a high non-HDL cholesterol level, they have more harmful cholesterol in their body.

This article looks at what non-HDL cholesterol means, what cholesterol levels fall within the healthy range, and how to lower cholesterol levels that are too high.

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Cholesterol is a waxy substance that the liver produces. Lipoproteins are a type of protein that transports cholesterol around the body.

The body requires a certain amount of cholesterol to help cells function, but high levels of some types of cholesterol can increase the risk of cardiovascular disease (CVD).

A doctor may assess different types of cholesterol:

LDL transports cholesterol to tissues in the body, and it can build up in the arteries, which increases the risk of stroke, heart disease, and heart attacks. People may refer to LDL as “bad” cholesterol.

HDL transports cholesterol to the liver, where the body breaks it down or disposes of it. People may refer to HDL as “good” cholesterol.

Triglycerides are a type of fat in the blood. High levels can increase the risk of heart disease and stroke.

Non-HDL cholesterol refers to all the types of cholesterol other than HDL cholesterol.

Higher levels of HDL cholesterol are beneficial for health, whereas the other types can increase the risk of CVD.

A non-HDL test reveals the combined total cholesterol levels in the blood, excluding HDL cholesterol.

From a blood sample, a doctor will take the HDL cholesterol measurement and subtract this from the total cholesterol level to find the non-HDL amount.

According to a 2017 article, non-HDL cholesterol levels may be a more important indicator of CVD risk than LDL cholesterol levels.

There is no set normal range for non-HDL cholesterol levels because test results need to account for individual factors such as:

  • age
  • sex
  • overall health and medical history
  • family history, particularly any history of CVD
  • lifestyles, such as smoking or other factors that can affect heart health

According to the Centers for Disease Control and Prevention (CDC), normal or desirable levels of cholesterol are as follows:

  • LDL cholesterol: The level should be below 100 milligrams per deciliter (mg/dl).
  • HDL cholesterol: The ideal amount is 60 mg/dl or more.
  • Triglycerides: Desirable levels are those below 150 mg/dl.
  • Total cholesterol: Doctors consider levels below 200 mg/dl to be healthy.

According to the American Heart Association (AHA), normal ranges are not as important as a person’s overall risk of CVD.

Doctors will assess the person’s cholesterol levels alongside other possible risk factors.

A 2017 study involving 4,832 males looked at the link between non-HDL cholesterol levels and the risk of death from CVD.

At a 22-year follow-up, the researchers found that non-HDL levels of 190 milligrams per deciliter (mg/dl) or more had a significant link to CVD mortality.

If people have high non-HDL cholesterol levels, lifestyle changes and medications may help lower them.

Research from 2018 suggests that dietary cholesterol — meaning that from foods containing cholesterol — does not increase blood cholesterol levels or the risk of CVD.

As a result of this research, the Dietary Guidelines for Americans no longer recommend limiting dietary cholesterol to 300 mg per day.

However, many foods that are high in cholesterol, such as meat, cheese, and butter, are also high in saturated fats, which may increase the risk of CVD. The exceptions are eggs and shrimp.

According to the AHA, a high intake of saturated fats increases LDL cholesterol levels in the blood, which can increase the risk of heart disease and stroke.

Researchers are still debating the effects of saturated fats on heart health. A 2019 review suggests that trans fats, but not saturated fats, increase the risk of CVD.

The AHA recommends that people limit or avoid trans fats. Trans fats increase LDL cholesterol levels and reduce HDL cholesterol levels. As a result, they increase the risk of heart disease, stroke, and type 2 diabetes.

The CDC advises people to limit their intake of trans fats, saturated fats, added sugars, and foods high in salt. Instead, people may choose:

Eating unsaturated fats and foods high in fiber may help control LDL and triglyceride levels and increase HDL levels. These foods include:

Regular physical activity can also help lower unhealthy cholesterol levels.

Adults can aim for at least 30 minutes of moderate intensity exercise a day, while children and adolescents can aim for 60 minutes a day.

Other lifestyle changes that can help include:

  • maintaining a moderate weight, as excess body fat can increase LDL levels and slow down the removal of LDL cholesterol from the body
  • quitting smoking, if applicable, as it can damage blood vessels and increase the rate of plaque buildup in the arteries
  • limiting alcohol intake, if applicable, as excess alcohol increases triglyceride levels

People with high non-HDL cholesterol levels may also require medications to lower their cholesterol. The options may include:

However, research from 2017 found that although niacin reduces LDL cholesterol and triglycerides while increasing HDL cholesterol, it does not reduce the risk of cardiovascular events.

This section looks at the different types of cholesterol levels.

HDL cholesterol

People may refer to HDL cholesterol as good cholesterol, as higher levels of HDL may have protective effects against heart attack and stroke.

HDL cholesterol absorbs cholesterol circulating in the blood and transports it to the liver. The liver can then remove the excess cholesterol from the body.

LDL cholesterol

People may refer to LDL cholesterol as bad cholesterol, as high levels of LDL increase the risk of CVD, and low levels are better for heart health.

LDL is fat in the blood that transports cholesterol around the body for cell repair and deposits excess cholesterol in the walls of the arteries.

Triglycerides

Triglycerides are the most common form of fat in the body. The body makes triglycerides, and they also come from food.

If people have high levels of triglycerides, they may also have high levels of LDL, low levels of HDL, and high total cholesterol.

Total cholesterol

A person’s total blood cholesterol is the sum of their HDL and LDL cholesterol levels together with 20% of their triglyceride levels.

Non-HDL cholesterol

Non-HDL cholesterol refers to any cholesterol that is not HDL cholesterol. It may be harmful to health at high levels.

People can calculate their non-HDL cholesterol by subtracting their HDL cholesterol amount from their total cholesterol amount.

Non-HDL cholesterol is the cholesterol in the body that is not HDL cholesterol. HDL cholesterol has protective effects against cardiovascular problems, such as heart disease and stroke.

High levels of LDL cholesterol and triglycerides can increase the risk of CVD.

A blood test, which doctors may refer to as a lipid profile, can show cholesterol levels. Subtracting the HDL cholesterol level from the total cholesterol level provides the non-HDL cholesterol level.