What are the normal ranges for total cholesterol and High-Density Lipoprotein (HDL) cholesterol?

From the Guidelines

Healthy cholesterol levels include a total cholesterol below 200 mg/dL and HDL (good cholesterol) above 40 mg/dL for men and above 50 mg/dL for women, as recommended by the most recent guidelines 1. The guidelines suggest that ideally, total cholesterol should be between 125-200 mg/dL, with HDL levels optimally above 60 mg/dL for both genders. Some key points to consider when evaluating cholesterol levels include:

• Total cholesterol levels can be measured at any time of day in nonfasting patients, but a fasting lipid profile provides more complete information about the child’s cholesterol status 1.
• The American Heart Association recommends monitoring the cholesterol levels of children in families in which adverse cardiovascular health factors are present, including premature CAD or family history of hypercholesterolemia 1.
• Lowering LDL cholesterol with a statin is associated with a reduction in cardiovascular events, and statins have emerged as first-line therapies for cholesterol lowering 1.
• The 2013 ACC/AHA guideline recommends fixed-dose strategies instead of targeted goals to lower blood cholesterol, and suggests that patients with established ASCVD should receive cholesterol-lowering drugs 1. Some important cholesterol categories to consider are:
• Very high: LDL-C ≥175 mg/dL, non-HDL-C ≥200 mg/dL
• High: LDL-C 150–174 mg/dL, non-HDL-C 175–199 mg/dL
• Borderline high: LDL-C 125–149 mg/dL, non-HDL-C 150–174 mg/dL
• Borderline low: LDL-C 100–124 mg/dL, non-HDL-C 125–149 mg/dL
• Low: LDL-C 75–99 mg/dL, non-HDL-C 100–124 mg/dL
• Very low: LDL-C 50–74 mg/dL, non-HDL-C 75–99 mg/dL It's worth noting that the degree of risk reduction depends on the extent of lowering, not on the therapeutic modality, and that statins lower LDL-C by 35% to 55%, depending on the type and dose 1.

From the Research

Normal Ranges for Total Cholesterol and HDL Cholesterol

• The normal range for total cholesterol is classified as follows:
  • Less than 200 mg/dL is considered "desirable blood cholesterol" 2, 3
  • 200 to 239 mg/dL is considered borderline-high blood cholesterol 2, 3
  • Greater than or equal to 240 mg/dL is considered high blood cholesterol 2, 3
• For HDL cholesterol, the recommended levels are not explicitly stated in the provided studies, but it is mentioned that HDL-C levels should be considered in the treatment of hypercholesterolemia 4, 5
• According to the National Cholesterol Education Program, the guidelines for HDL-C are not specified in the provided studies, but it is recommended to measure HDL-C levels as part of the lipoprotein analysis 2

Classification of Cholesterol Levels

• The classification of cholesterol levels is based on the LDL-cholesterol level, with a value of less than 130 mg/dL considered desirable 3
• The treatment of hypercholesterolemia is based on the LDL-cholesterol level and the presence of other coronary heart disease risk factors 2, 6

Treatment of Hypercholesterolemia

• Dietary therapy is the primary cholesterol-lowering treatment, and drug treatment should be considered if LDL-cholesterol exceeds specified levels after six months of intensive dietary therapy 2
• Combination therapies with lipid-lowering drugs that have different mechanisms of action are recommended when it is not possible to attain LDL-C targets with statin monotherapy 4