Non-HDL cholesterol: the number your GP now watches

If you've had a cholesterol blood test, you may have noticed a result called non-HDL cholesterol on your report. But what does it mean, and why is it included alongside results such as LDL and HDL?

Non-HDL cholesterol gives you a broader picture of the cholesterol in your blood and is one of the numbers healthcare professionals may consider when assessing your cardiovascular health.

What is non-HDL cholesterol?

Non-HDL cholesterol is a measure of all the cholesterol in your blood that isn't carried by HDL, often known as 'good' cholesterol.

You can work it out by subtracting your HDL cholesterol from your total cholesterol. The result includes cholesterol carried by several different types of particles, including:

• LDL
• VLDL
• IDL
• Remnant particles
• Lipoprotein(a)

You don't need to remember what all of these mean. The important thing is that non-HDL cholesterol gives a broader picture of the cholesterol in your blood than looking at LDL alone.

Some types of cholesterol can contribute to fatty buildup in the artery walls over time. This is known as atherosclerosis and can increase the risk of cardiovascular disease.

Why does non-HDL cholesterol matter?

Total cholesterol gives you an overall number, but it doesn't tell the whole story.

Non-HDL cholesterol includes several types of cholesterol that can contribute to fatty build-up in the arteries. This makes it a useful number to look at alongside your other cholesterol results.

It's also useful because you don't usually need to fast before a cholesterol test. This means a lipid profile can often be taken as part of a routine health assessment without having to skip breakfast beforehand.

Your non-HDL result shouldn't be looked at on its own, though. Your GP or healthcare professional may consider it alongside your LDL, HDL, triglycerides, cholesterol ratio and other factors that affect your risk of cardiovascular disease.

What is a healthy non-HDL cholesterol level?

For healthy adults, a non-HDL cholesterol level below 4.0 mmol/L is generally used as a healthy guide.

Lower levels are generally better, but your result needs to be considered alongside your other cholesterol results and your wider health.

A higher result doesn't necessarily mean you have heart disease. It simply means there may be something worth keeping an eye on or discussing with your GP, depending on your overall risk.

What does a high non-HDL cholesterol result mean?

Raised non-HDL cholesterol is linked with a higher risk of cardiovascular disease, including heart disease and stroke.

The tricky thing about high cholesterol is that it usually doesn't cause any symptoms. You can feel perfectly well while your cholesterol levels are higher than they should be.

That's one reason regular blood tests can be useful. They can highlight changes in your cholesterol before you notice anything yourself.

If your non-HDL cholesterol is higher than the recommended range, your GP can look at your full cholesterol profile and other aspects of your health to work out what it means for you.

What can affect your non-HDL cholesterol?

Your cholesterol levels are influenced by a mixture of lifestyle, health and genetic factors.

Things that can affect your cholesterol include:

• Eating a diet high in saturated fat
• Not getting enough physical activity
• Being overweight
• Smoking
• Drinking too much alcohol
• Some health conditions
• Certain medicines
• Family history and genetics

It's worth remembering that high cholesterol isn't always down to your lifestyle. Some people naturally have higher cholesterol because of their genes, even if they eat well and exercise regularly.

How can you lower non-HDL cholesterol?

If your cholesterol is higher than recommended, making some changes to your diet and lifestyle may help improve your levels.

Eat more fibre

Foods such as oats, beans, lentils, chickpeas, fruit and vegetables can help you get more fibre into your diet. Oats are particularly useful because they contain a type of soluble fibre called beta-glucan, which can help lower LDL cholesterol when eaten regularly.

Choose more beans and pulses

Beans, chickpeas, peas and lentils are naturally low in saturated fat and provide fibre and plant-based protein. Try adding them to soups, stews, salads or other meals as an easy way to include more plant-based foods in your diet.

Swap saturated fats for unsaturated fats

Too much saturated fat can raise LDL and non-HDL cholesterol. Try swapping foods such as butter, fatty and processed meats, full-fat dairy products, cakes and biscuits for foods containing unsaturated fats, such as olive or rapeseed oil, nuts, seeds and oily fish.

Keep active

Regular physical activity can support your heart health and help improve your overall cholesterol profile. You don't necessarily need to make dramatic changes. Building more movement into your everyday routine can be a good place to start.

Don't smoke

Smoking increases your risk of cardiovascular disease. If you smoke, stopping can have significant benefits for your heart and overall health.

Maintain a healthy weight

If you're overweight, losing some weight can help improve your cholesterol levels and other factors linked to cardiovascular health.

Is non-HDL cholesterol the same as LDL?

No. LDL is one type of cholesterol-carrying particle, while non-HDL cholesterol includes LDL as well as several other types.

This means non-HDL cholesterol can give you a broader picture of the cholesterol in your blood. Both figures can be useful when looking at your overall cholesterol profile.

Do you need to fast for a non-HDL cholesterol test?

Usually not. Cholesterol tests can generally be carried out without fasting, which makes them easier to include as part of routine health screening.

If your particular test requires any preparation, you'll be given instructions when you book your appointment.

What should you do if your non-HDL cholesterol is high?

If your result is higher than the recommended range, there's no need to panic. A single cholesterol result doesn't tell you your overall risk of cardiovascular disease.

Look at your non-HDL result alongside your other cholesterol measurements and any guidance provided with your results.

If you're concerned about your cholesterol or your results remain high, speak to your GP. They can look at your full lipid profile alongside other factors such as your age, blood pressure, family history and general health.

FAQs

What is non-HDL cholesterol?

Non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. It includes cholesterol carried by LDL and several other types of particles in your blood.

What is a healthy non-HDL cholesterol level?

For healthy adults, a level below 4.0 mmol/L is generally used as a healthy guide. Your result should always be considered alongside your other cholesterol results and wider cardiovascular risk.

Is non-HDL cholesterol better than LDL?

Neither is necessarily 'better'. Non-HDL cholesterol includes LDL as well as other types of cholesterol, so it can provide additional information alongside your LDL result and the rest of your lipid profile.

Can you test non-HDL cholesterol without fasting?

Yes. Non-HDL cholesterol can be measured as part of a non-fasting lipid profile, so you will not usually need to fast before a cholesterol test.

Does high non-HDL cholesterol cause symptoms?

No. High cholesterol usually doesn't cause noticeable symptoms. A blood test is often the only way to know that your cholesterol levels are raised.

How can I lower my non-HDL cholesterol?

Eating more fibre, choosing unsaturated fats instead of saturated fats, staying active, maintaining a healthy weight and not smoking can all help support healthier cholesterol levels.

Take a closer look at your cholesterol with Bluecrest Wellness

If you'd like a clearer picture of your cholesterol levels, Bluecrest's cholesterol testing can help you understand your results, including non-HDL cholesterol.

Your results are presented in a clear, personalised report, helping you understand your numbers and identify anything you may want to discuss with a healthcare professional.

Explore cholesterol testing.

Need help? Call free on 0800 652 2183 to speak to one of our team.

This article is for general health information purposes and does not constitute medical advice. If you have concerns about your cholesterol results, please speak with a healthcare professional.