Non-HDL Cholesterol: A Better Measure of Heart Risk?
Captures all atherogenic particles in one number — and it's already on your lipid panel.
Private
Calculated on your device
Evidence-based
Major guideline-endorsed
Actionable
Improves with lifestyle
Who is this especially useful for?
- •LDL looks normal, but you have high triglycerides
- •You have metabolic syndrome or type 2 diabetes
- •Your labs were done non-fasting (non-HDL stays accurate)
Non-HDL is not a diagnosis — it's a comprehensive atherogenic burden measure.
For decades, LDL cholesterol has been the headline number on lipid panels. Your doctor probably focuses on it. Statin trials target it. But there's a case to be made that a different number — one you can calculate in seconds from the same lab report — is actually more informative.
Non-HDL cholesterol is simply your total cholesterol minus your HDL ("good") cholesterol. This single calculation captures all the potentially artery-clogging particles: LDL, VLDL, IDL, and even Lp(a). Many experts now argue it should be the primary lipid target.
Calculate yours now
Enter your total cholesterol and HDL values from your most recent lab work into our free Non-HDL calculatorto see where you stand.
What is Non-HDL Cholesterol?
The math is elegantly simple: take your total cholesterol and subtract your HDL cholesterol.
Total Cholesterol includes all cholesterol-carrying particles in your blood — the good (HDL), the bad (LDL), and the ugly (VLDL, IDL, Lp(a)).
HDL cholesterol is the "good" cholesterol that helps remove excess cholesterol from your arteries. When you subtract it, what remains is everything that can contribute to plaque buildup.
The Formula
Non-HDL = Total Cholesterol − HDL
Simple, no fasting required for accuracy • Already on every standard lipid panel
Example Calculation
200
Total Cholesterol (mg/dL)
50
HDL (mg/dL)
Your Non-HDL
150 mg/dL
How to Find These Numbers on Your Lab Report
Both values come from a standard lipid panel — one of the most common blood tests.
Total Cholesterol
Usually listed as "Total Cholesterol" or "TC" at the top of the lipid panel
HDL Cholesterol
Listed as "HDL" or "HDL-C" — this is the "good" cholesterol
💡 Check your units: US labs typically use mg/dL, while European labs often use mmol/L. Our calculator handles both.
I have my numbers →Why Non-HDL May Be Better Than LDL
LDL has been the focus for decades, but non-HDL offers several advantages that make it a more complete cardiovascular risk measure.
Captures all atherogenic particles
LDL only measures one type. Non-HDL includes LDL + VLDL + IDL + Lp(a) — everything that can build plaque.
No fasting required
LDL calculations (Friedewald) become unreliable with elevated triglycerides or non-fasting samples. Non-HDL stays accurate.
Better predictor in key populations
Multiple studies show non-HDL outperforms LDL in people with metabolic syndrome, diabetes, or high triglycerides.
Already available
You don't need special tests. It's on every lipid panel — just not calculated or highlighted.
Three Perspectives on Non-HDL
Different health paradigms interpret these thresholds differently:
ATP III targets. Goal for high-risk = LDL goal + 30.
Functional medicine targets tighter ranges for prevention.
Context-dependent. Higher TG = more important to track non-HDL.
Three Perspectives on Non-HDL
Different health paradigms interpret these thresholds differently:
mg/dL (US)
Standard Medical
ATP III targets. Goal for high-risk = LDL goal + 30.
Research Consensus
Functional medicine targets tighter ranges for prevention.
Metabolic Focus
Context-dependent. Higher TG = more important to track non-HDL.
mmol/L (International)
Standard Medical
ATP III targets. Goal for high-risk = LDL goal + 0.8.
Research Consensus
Functional medicine targets tighter ranges for prevention.
Metabolic Focus
Context-dependent. Higher TG = more important to track non-HDL.
Learn more about these paradigms
What about Lp(a)?
Non-HDL includes Lp(a), a genetically-determined risk factor that's not captured by LDL alone. If your non-HDL is high despite controlled LDL and triglycerides, ask your doctor about testing Lp(a) — it may be the hidden contributor.
The Evidence Behind Non-HDL
Major clinical guidelines have recognized non-HDL as a valuable — and in some cases, superior — lipid target. The ATP III guidelines established it as a secondary target, while many cardiologists now argue it should be primary.
ATP III
Guideline Endorsed
Non-HDL as secondary target for elevated TG
NCEP ATP III, 2002
Better
Risk Prediction
Than LDL in PROVE IT-TIMI 22 trial
Boekholdt et al., JAMA 2012
+30
Rule of Thumb
Non-HDL goal = LDL goal + 30 mg/dL
ATP III Guidelines
The research is compelling
A 2012 meta-analysis in JAMA examined data from over 62,000 statin-treated patients across 8 trials. Non-HDL cholesterol was a better predictor of cardiovascular events than LDL cholesterol.
The 2011 Sniderman meta-analysis of 223,000+ participants across 12 studies found that non-HDL and apoB outperformed LDL for predicting cardiovascular risk.
Critically, the advantage of non-HDL is most pronounced in people with metabolic syndrome, diabetes, or high triglycerides — precisely the populations where LDL measurements become unreliable.
What labs typically highlight
LDL Cholesterol
What captures more risk
Non-HDL Cholesterol
(all atherogenic particles)
When Non-HDL Matters Most
The difference between LDL and non-HDL becomes clinically important in specific situations.
Non-HDL is especially valuable when:
- Triglycerides are elevated (>150 mg/dL) — LDL calculations become unreliable
- Metabolic syndrome or diabetes — more VLDL particles contribute to risk
- Non-fasting blood draw — non-HDL stays accurate while LDL doesn't
- LDL-nonHDL discordance — when LDL looks normal but non-HDL is elevated
The +30 Rule: Setting Your Non-HDL Goal
The ATP III guidelines established a simple rule: your non-HDL goal should be 30 mg/dL higher than your LDL goal.
The 30 mg/dL difference accounts for the VLDL cholesterol contribution (normal VLDL-C is ~30 mg/dL).
How to Improve Your Non-HDL
Since non-HDL reflects multiple atherogenic particles, a comprehensive approach works best — targeting both LDL and triglyceride-rich lipoproteins.
Lower LDL Component
- •Reduce saturated fat — shift to olive oil, avocado, nuts
- •Increase soluble fiber — oats, beans, psyllium
- •Consider plant sterols — 2g/day can reduce LDL 5-10%
- •Statin therapy — if lifestyle isn't sufficient
Lower VLDL/TG Component
- •Cut refined carbs and sugars — dramatic TG improvement in 2-4 weeks
- •Limit alcohol — even moderate drinking raises triglycerides
- •Add omega-3s — fatty fish 2-3x per week or EPA/DHA supplements
- •Lose excess weight — improves the entire lipid profile
How fast can you see results?
Non-HDL can improve within 4-8 weeks of dietary changes. The triglyceride component responds fastest (2-4 weeks), while LDL shifts take longer. Consistent lifestyle changes show meaningful improvement within 2-3 months.
Key Takeaways
- Non-HDL = Total Cholesterol − HDL (simple 3-second calculation)
- Captures all atherogenic lipoproteins — LDL + VLDL + IDL + Lp(a)
- More accurate than LDL when triglycerides are elevated or sample is non-fasting
- Major guidelines endorse non-HDL as a secondary target (some argue it should be primary)
- Non-HDL goal = LDL goal + 30 mg/dL
- Responds to both LDL-lowering and triglyceride-lowering strategies
Related Tools
Non-HDL Calculator
Calculate your level now
Remnant-C Calculator
Related CVD marker
TG/HDL Calculator
Metabolic health marker
References
- Third Report of the NCEP Expert Panel (ATP III). Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Circulation, 2002. PMID: 12485966
- Boekholdt SM et al. Association of LDL cholesterol, non-HDL cholesterol, and apoB with cardiovascular events. JAMA, 2012. PMID: 22453571
- Sniderman AD et al. A meta-analysis of LDL-C, non-HDL-C, and apoB as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes, 2011. PMID: 21487090
- Brunzell JD et al. Lipoprotein management in patients with cardiometabolic risk. Diabetes Care, 2008. PMID: 18375431
- Robinson JG et al. Non-HDL-C, apoB and mortality risk. J Am Coll Cardiol, 2009. PMID: 19695458
Medical Disclaimer: This article is for educational purposes only and is not intended as medical advice. Information presented is based on peer-reviewed research but should not be used for self-diagnosis. Always discuss your lab results with your healthcare provider.