LDL, HDL, Non-HDL and Triglycerides: What Your Cholesterol Test Results Actually Mean

Reviewed by GPhC Pharmacist at Halton Phamacy, Leeds

Cholesterol isn’t just one number. A full lipid profile actually measures four different things. Each one tells doctors something different about your heart health, and each may need a different response.

At Halton Pharmacy in Leeds, cholesterol testing is part of our Heart and Metabolic Health Hub assessment. We explain each number to you in the context of your overall heart risk.

This guide covers what each measurement means  and why non-HDL cholesterol is now seen as the single most useful number for assessing heart risk.

The Four Parts of a Lipid Profile

A standard lipid test measures:

• Total cholesterol — the combined level of all the types. On its own, this tells you the least.
• LDL cholesterol (“bad” cholesterol) — carries it to your artery walls. It’s the main driver of atherosclerosis (plaque buildup that leads to most heart attacks and strokes).
• HDL cholesterol (“good” cholesterol) — carries it away from artery walls, back to the liver. It protects against heart disease.
• Triglycerides — a type of fat in your blood. High levels raise heart risk on their own, and are linked to insulin resistance and metabolic syndrome.
  
  

LDL Cholesterol: The Main Target

LDL is most closely linked to plaque buildup in arteries.

• NICE guidelines recommend adults at higher heart risk aim to lower LDL by more than 40% from their starting point.
• The goal for non-HDL cholesterol is below 2.5 mmol/L.
• LDL can be calculated from a standard blood test without fasting, using the Friedewald equation.
• High LDL causes “foam cells” to form in artery walls  this is the first step in plaque buildup.
  
  

HDL Cholesterol: The Protective Type

HDL clears cholesterol from artery walls and sends it back to the liver for removal. This process is called reverse cholesterol transport.

• Low HDL is its own risk factor for heart disease, separate from LDL.
• Low HDL is defined as:
  
  • Below 1.0 mmol/L in men
  • Below 1.2 mmol/L in women
• Unlike LDL, HDL is hard to raise with medication. The best ways to raise it are aerobic exercise and quitting smoking.
  
  

Non-HDL Cholesterol: The Number That Matters Most

Non-HDL cholesterol = Total cholesterol − HDL.

This one number captures all the cholesterol types that can cause plaque buildup, including:

• LDL
• VLDL (very low-density lipoprotein)
• IDL (intermediate-density lipoprotein)
• Lp(a)

NICE, the Joint British Societies, and the European Society of Cardiology all recommend non-HDL cholesterol as the preferred target. Two reasons:

1. It captures the full picture of plaque-forming particles  more than LDL alone.
2. You don’t need to fast before the test.
   
   
   

Targets:

(Secondary prevention targets are from NICE guideline NG238.)

At Halton Pharmacy, we explain your non-HDL result alongside your overall heart risk score, and let you know if it’s worth speaking to your GP about lifestyle changes or medication.

Triglycerides: The Overlooked Marker

Triglycerides are a type of fat that builds up when you eat more calories than your body uses.

• Elevated: above 1.7 mmol/L (fasting)
• High risk of pancreatitis: above 10 mmol/L
  
  

High triglycerides are strongly linked to:

• Insulin resistance
• Type 2 diabetes
• Excess belly fat
• Metabolic syndrome
  
  

Good news: triglycerides usually respond well to lifestyle changes:

• Cutting back on refined carbs and alcohol
• More aerobic exercise
• Weight loss
  
  

If levels stay high despite these changes, medication may be needed.

Testing at Halton Pharmacy

Our Heart and Metabolic Health Hub offers cholesterol and HbA1c testing using a simple fingerprick blood sample.

• Results are ready during or shortly after your appointment
• Our team explains each part of your lipid profile and how it affects your heart risk score
• We’ll flag anything worth discussing with your GP
• No fasting required for non-HDL cholesterol or HbA1c testing
  
  

This article is for general information only and does not replace individual clinical advice.

Book a free blood pressure check or Heart and Metabolic Health assessment:
Halton Pharmacy, 253 Selby Road, Halton, Leeds LS15 7JR
Walk in or book an appointment — no GP referral required.