For most adults, total cholesterol should be below 200 mg/dL, LDL (“bad”) cholesterol below 100 mg/dL, and HDL (“good”) cholesterol at 60 mg/dL or above. But these general targets shift depending on your age, sex, and cardiovascular risk factors, so the full picture is more nuanced than a single number.
Healthy Ranges for Adults
A standard lipid panel measures four things. Here’s where each one should land for adults age 20 and older:
- Total cholesterol: below 200 mg/dL
- LDL cholesterol: below 100 mg/dL
- HDL cholesterol: 60 mg/dL or higher is ideal. Below 40 mg/dL in men or below 50 mg/dL in women is considered low.
- Non-HDL cholesterol: below 130 mg/dL
- Triglycerides: below 150 mg/dL (150 to 199 is borderline high, 200 or above is high)
HDL is the one number you want to be higher, not lower. It helps remove cholesterol from your bloodstream. Every other number on your panel, you want as low as reasonably possible.
Targets Change Based on Your Risk
The general targets above apply to people at average cardiovascular risk. If you already have heart disease, diabetes, or a high estimated risk of a cardiovascular event in the next 10 years, your doctor will aim for tighter numbers. The 2026 ACC/AHA guidelines, which replaced the previous 2018 version, brought back specific LDL goals for different risk levels:
- Borderline or intermediate risk (3% to under 10% ten-year risk): LDL below 100 mg/dL, non-HDL below 130 mg/dL
- High risk (10% or greater ten-year risk): LDL below 70 mg/dL, non-HDL below 100 mg/dL
- Very high risk (existing heart disease or prior cardiovascular event): LDL below 55 mg/dL, non-HDL below 85 mg/dL
People with diabetes and at least one additional risk factor generally fall into the high-risk category, with an LDL goal below 70 mg/dL. Those with diabetes who also have established cardiovascular disease are treated as very high risk, targeting below 55 mg/dL.
Cholesterol Ranges for Children and Teens
For anyone 19 or younger, the healthy thresholds are lower than adult targets:
- Total cholesterol: below 170 mg/dL
- LDL: below 110 mg/dL
- Non-HDL: below 120 mg/dL
- HDL: above 45 mg/dL
Medication is rarely considered in children. It typically only comes into the conversation for kids age 10 or older whose LDL stays above 190 mg/dL after six months of diet and exercise changes, or above 160 mg/dL if they also have other risk factors for heart disease.
Non-HDL Cholesterol and Why It Matters
You may notice that guidelines now emphasize non-HDL cholesterol alongside LDL. Non-HDL is simply your total cholesterol minus your HDL. It captures all the cholesterol carried on particles that can build up in artery walls, not just LDL. In some people, LDL looks fine but non-HDL reveals a bigger problem because of elevated triglyceride-rich particles that LDL alone doesn’t account for.
When LDL and non-HDL tell different stories, cardiovascular risk tends to track more closely with non-HDL. For general screening, a non-HDL below 130 mg/dL is the standard target. For people at high cardiovascular risk, the goal drops to below 100 mg/dL, and for very high risk, below 85 mg/dL.
When Statins Enter the Picture
Cholesterol-lowering medication isn’t automatically prescribed at a specific LDL number. The decision depends on your overall risk profile. That said, there are some clear thresholds where treatment is strongly recommended:
- LDL at or above 190 mg/dL: Statin therapy is recommended regardless of other risk factors. A formal 10-year risk calculation isn’t even necessary at this level.
- Diabetes with LDL at or above 70 mg/dL (ages 40 to 75): Moderate-intensity statin therapy is typically started.
- No diabetes, LDL at or above 70 mg/dL, and 10-year risk of 7.5% or higher (ages 40 to 75): Statin therapy should be discussed.
For people already on maximum statin therapy who still haven’t reached their LDL goal, additional medications can be added. The 2026 guidelines reinforce this “treat to target” approach, meaning the aim is to get your LDL to a specific number rather than simply prescribing a statin and hoping for the best.
How Often to Get Tested
The CDC recommends cholesterol screening begin in childhood. Children should have their cholesterol checked at least once between ages 9 and 11, and again between 17 and 21. After that, most healthy adults need a check every four to six years. People with heart disease, diabetes, or a family history of high cholesterol should be tested more frequently.
You may have heard you need to fast for 9 to 12 hours before a cholesterol test. Current guidance from major medical organizations considers a non-fasting test equally acceptable for screening purposes. Total cholesterol and HDL barely change whether you’ve eaten or not. The one exception is if your triglycerides are known to be significantly elevated, in which case fasting gives a more accurate reading. If your doctor orders a fasting panel, there’s usually a specific reason, but for routine screening, eating beforehand won’t meaningfully skew your results.
What Moves the Numbers
About 75% to 80% of the cholesterol in your blood is made by your liver, which is why genetics play such a large role. Some people eat well and exercise regularly and still have high LDL. Others eat poorly and have normal numbers. That said, lifestyle changes reliably improve cholesterol for most people.
Replacing saturated fat (found in red meat, butter, full-fat dairy, and coconut oil) with unsaturated fat (olive oil, nuts, avocados, fatty fish) is the single most effective dietary change for lowering LDL. Soluble fiber, found in oats, beans, lentils, and certain fruits, binds cholesterol in the gut and helps remove it. Regular aerobic exercise raises HDL and lowers triglycerides. Losing excess weight, even a modest 5% to 10% of body weight, improves nearly every number on a lipid panel.
Smoking lowers HDL and damages artery walls in ways that make cholesterol buildup worse. Quitting raises HDL within weeks. Alcohol in excess raises triglycerides. These factors interact with each other and with genetics, which is why your cholesterol numbers are best interpreted alongside your full health picture rather than in isolation.