A healthy total cholesterol level is below 200 mg/dL for adults age 20 and older, and below 170 mg/dL for anyone 19 or younger. But total cholesterol is only part of the picture. Your LDL (“bad” cholesterol), HDL (“good” cholesterol), and triglycerides each have their own target ranges, and those targets shift depending on your age, sex, and overall heart disease risk.
Cholesterol Targets for Children and Teens
For anyone age 19 or younger, the healthy thresholds are lower than adult levels. Total cholesterol should be below 170 mg/dL, and LDL should be below 110 mg/dL. Children whose LDL climbs above 190 mg/dL despite six months of diet and exercise changes may need medical treatment. The threshold drops to 160 mg/dL for kids who also have other risk factors for heart disease.
The CDC recommends children get their cholesterol checked at least once between ages 9 and 11, with a second screening between ages 17 and 21. Kids with obesity, diabetes, or a family history of high cholesterol may need testing more frequently.
Healthy Ranges for Adults 20 and Older
Once you hit 20, the target numbers shift. Here’s what’s considered healthy for adults:
- Total cholesterol: below 200 mg/dL
- LDL cholesterol: below 100 mg/dL
- Non-HDL cholesterol: below 130 mg/dL
- Triglycerides: below 150 mg/dL
HDL cholesterol is the one number where higher is better. For men, 60 mg/dL or above is ideal, and anything below 40 mg/dL is considered low. For women, the ideal is also 60 mg/dL or above, but the low threshold is higher: below 50 mg/dL is considered a concern. This sex-based difference in HDL is one of the few places where the standard targets differ between men and women.
Triglycerides follow a clear escalation: below 150 is healthy, 150 to 199 is borderline high, 200 to 499 is high, and 500 or above is very high.
Why Cholesterol Rises With Age
Your cholesterol levels at 25 and 55 will likely look very different, even if your diet hasn’t changed much. That’s because aging itself changes how your body handles cholesterol. Research using isotope analysis has shown that the body’s ability to clear LDL from the bloodstream declines with age. Your liver also produces less bile acid as you get older, and bile acid is one of the main ways your body breaks down and eliminates cholesterol. The combined effect is that total cholesterol and LDL tend to creep upward over the decades.
This is why most healthy adults should have their cholesterol checked every four to six years, with more frequent testing for people who have heart disease, diabetes, or a family history of high cholesterol.
How Menopause Affects Women’s Cholesterol
Women often see a noticeable shift in their cholesterol profile during and after menopause. LDL cholesterol increases as women transition through menopause. HDL cholesterol numbers may actually go up on a standard blood test, which sounds like good news, but research from the SWAN-HDL Study found that the internal composition of those HDL particles changes in ways that make them less protective. So the number on the lab report can be misleading. Women in their late 40s and 50s should pay particular attention to LDL trends, even if their HDL looks fine.
Risk-Based Targets After 30
The latest guidelines from the American College of Cardiology and American Heart Association (published in 2026) don’t simply assign one LDL target to all adults. Instead, they calculate your 10-year risk of heart disease using factors like age, blood pressure, cholesterol levels, diabetes status, and kidney function, then set targets accordingly.
For adults aged 30 to 79 with LDL between 70 and 189 mg/dL, the risk categories break down like this:
- Low risk (under 3%): Lifestyle changes are the primary recommendation. If LDL is between 160 and 189 mg/dL, medication may be reasonable even at low risk because of the cumulative exposure over time.
- Borderline risk (3% to under 5%): A treatment goal of LDL below 100 mg/dL and non-HDL below 130 mg/dL is reasonable.
- Intermediate risk (5% to under 10%): The same LDL target of below 100 applies, with more intensive treatment for those at the higher end of this range.
- High risk (10% or greater): The goal tightens to LDL below 70 mg/dL and non-HDL below 100 mg/dL.
Adults with diabetes between ages 40 and 75 who don’t already have heart disease are generally treated to an LDL goal below 100 mg/dL regardless of their calculated risk score.
Cholesterol Management After 65
For older adults, cholesterol management becomes more individualized. There’s no single target number that applies to everyone over 65 or 75. Clinicians look at the full picture: other health conditions, medications that might interact with cholesterol-lowering drugs, and the person’s overall priorities. In some cases, the side effects of aggressive treatment may outweigh the cardiovascular benefits. In others, particularly for people without many competing health problems, treating high cholesterol remains a priority. The key point is that the “healthy” level for a 78-year-old depends heavily on what else is going on with their health.
Fasting Before Your Cholesterol Test
Whether you need to fast before a lipid panel depends on how the results will be used. Many guidelines now support non-fasting blood draws for routine screening, which is more convenient since you don’t need a separate early-morning appointment. Non-fasting triglyceride and non-HDL levels may actually be better at predicting cardiovascular risk in some cases. However, if your doctor is making a specific treatment decision based on your LDL number, a fasting draw (typically 9 to 12 hours without food) gives a more precise measurement. International guidelines remain split on this, so your doctor may have a preference either way. If you’re unsure, ask when you schedule the test.