You have had a cholesterol blood test and you are looking at a set of numbers — total cholesterol, LDL, HDL, non-HDL, triglycerides — and trying to work out whether they are good, acceptable, or cause for concern. It is a reasonable thing to want to understand clearly, but the answer is not quite as simple as a single target figure. UK guidance has been updated significantly in recent years, and what counts as a good cholesterol level in the UK depends on which component of the lipid profile you are looking at, whether you already have cardiovascular disease, and a range of individual risk factors that only a GP can properly assess.
Understanding Your Cholesterol Test Results
A full cholesterol blood test — properly called a lipid profile or lipid panel — does not produce a single number. It produces five separate values, each of which tells you something different about your cardiovascular risk. Understanding what each one means is the starting point for interpreting whether your results are good.
Total Cholesterol (TC)
The combined amount of all cholesterol in your blood — both LDL and HDL together. The general UK population target is below 5.0 mmol/L for healthy adults.
LDL Cholesterol (Low-density Lipoprotein)
Often called ‘bad’ cholesterol. LDL carries cholesterol to the artery walls and is the primary driver of atherosclerosis. The lower your LDL, the better — this is now the key treatment target in UK clinical guidelines.
HDL Cholesterol (High-density Lipoprotein)
Often called ‘good’ cholesterol. HDL carries cholesterol away from the arteries and back to the liver. Higher HDL is protective. Unlike LDL, you want this one to be higher.
Non-HDL Cholesterol
Total cholesterol minus HDL. This figure captures all the atherogenic (artery-narrowing) lipoproteins — including LDL, VLDL, and IDL — in a single number. Non-HDL is now the primary treatment target in NICE NG238 for primary prevention.
Triglycerides
A separate type of fat in the blood, associated with cardiovascular risk particularly when elevated alongside low HDL. Significantly affected by diet and alcohol intake.
Good Cholesterol Levels in the UK: The NHS and NICE Targets
The following reference ranges are drawn from NHS guidance, the British Heart Foundation, Heart UK, and NICE NG238. They apply to healthy adults without established cardiovascular disease — what clinicians call primary prevention. Targets are different, and lower, for people who already have cardiovascular disease (secondary prevention), which is covered separately below.
Total Cholesterol
- Good (healthy adult target): Below 5.0 mmol/L
- Borderline: 0 to 6.4 mmol/L — above the ideal target; warrants dietary review and risk assessment
- Mildly high: 5 to 7.8 mmol/L — clinically significant; treatment likely to be considered depending on overall risk profile
- Very high: Above 7.8 mmol/L — significantly elevated; familial hypercholesterolaemia (FH) should be considered if LDL is also very high
It is important to note that the total cholesterol figure on its own is the least clinically informative component of the lipid panel. Two people with the same total cholesterol can have very different cardiovascular risk profiles depending on how that total cholesterol is distributed between LDL, HDL, and other fractions. Total cholesterol is a useful screening indicator; it is not a sufficient basis for a clinical decision about treatment.
LDL Cholesterol (Primary Prevention — No Established Cardiovascular Disease)
- Good (healthy adult target): Below 3.0 mmol/L
- Borderline: 0 to 4.0 mmol/L — above target; lifestyle modification and risk assessment warranted
- High: Above 4.0 mmol/L — clinically significant elevation; treatment likely to be considered
- Very high (possible FH): Above 4.9 mmol/L, especially with family history of premature cardiovascular disease — familial hypercholesterolaemia should be considered and specialist referral may be appropriate
For people on lipid-lowering treatment for primary prevention, NICE NG238 sets a treatment response target of greater than 40% reduction in non-HDL cholesterol from baseline, rather than an absolute LDL figure. The British Journal of General Practice’s 2024 clinical update confirms that for primary prevention, the aim is for more than 40% reduction in non-HDL cholesterol.
HDL Cholesterol
- Good: Above 1.2 mmol/L for women; above 1.0 mmol/L for men
- Low (concerning): Below 1.0 mmol/L for women; below 0.9 mmol/L for men — low HDL is an independent cardiovascular risk factor
Heart UK notes that HDL levels up to 1.4 mmol/L are thought to offer the best protection, but that levels higher than this may not confer additional benefit. Very high HDL levels — above 2.5 mmol/L — have been associated in some research with paradoxical cardiovascular risk, and are assessed individually by clinicians rather than being straightforwardly ‘better’.
Non-HDL Cholesterol (Primary Prevention)
- Good (healthy adult target): Below 4.0 mmol/L
- Borderline: 0 to 5.0 mmol/L
- High: Above 5.0 mmol/L
Non-HDL cholesterol is NICE’s preferred primary prevention treatment target because it captures all atherogenic lipid particles — not just LDL — in a single figure and does not require a fasting sample to be accurate. Your GP will use non-HDL cholesterol as the primary benchmark when assessing whether your lipid profile warrants lifestyle modification, monitoring, or treatment.
Triglycerides
- Good: Below 1.7 mmol/L (fasting)
- Borderline high: 7 to 5.6 mmol/L — assess for dietary causes, alcohol intake, diabetes, and obesity
- High: Above 5.6 mmol/L — clinically significant; associated with pancreatitis risk at very high levels
- Very high: Above 20.0 mmol/L — urgent lipid specialist review required; significant pancreatitis risk
Cholesterol Targets After a Heart Attack or Stroke (Secondary Prevention)
For people who have already had a heart attack, stroke, TIA, or have established cardiovascular disease (coronary heart disease, peripheral arterial disease), the targets are significantly lower — reflecting the substantially higher cardiovascular risk in this group and the strong evidence base for intensive lipid lowering in secondary prevention.
- Total cholesterol target: Below 4.0 mmol/L (British Heart Foundation guidance)
- LDL cholesterol target: 0 mmol/L or below (NICE NG238, December 2023)
- Non-HDL cholesterol target: 6 mmol/L or below (NICE NG238)
Heart UK notes that for secondary prevention — those who already have cardiovascular disease — there are now specific targets for both non-HDL and LDL cholesterol, with a lower-is-better approach. NICE NG238 recommends atorvastatin 80 mg as the standard first-line treatment for secondary prevention regardless of baseline cholesterol level, with the December 2023 update formalising specific LDL and non-HDL targets for the first time.
Why Your QRISK3 Score Matters as Much as the Numbers
The cholesterol targets above are guides for the general population. What actually determines whether your cholesterol level is clinically ‘good enough’ for you specifically is your ten-year cardiovascular risk, calculated using the QRISK3 tool. QRISK3 is a validated risk calculator that incorporates your cholesterol:HDL ratio alongside age, sex, blood pressure, BMI, smoking status, deprivation, ethnicity, family history, diabetes, kidney disease, atrial fibrillation, rheumatoid arthritis, and several other variables.
NICE NG238 recommends considering statin therapy for primary prevention when QRISK3 reaches 10% or above — meaning a 10% or greater probability of a cardiovascular event in the next ten years. A person with a total cholesterol of 5.8 mmol/L but a QRISK3 of 4% may not need medication. A person with a total cholesterol of 5.2 mmol/L but a QRISK3 of 14% because of age, blood pressure, family history, and smoking almost certainly does. The cholesterol number provides context; the QRISK3 score provides the clinical decision framework.
This is the reason that a cholesterol test result needs to be reviewed by a GP rather than interpreted against a table of numbers alone. The numbers matter — but only in context.
What Affects Your Cholesterol Level?
Understanding what drives your cholesterol level helps you take meaningful action. The main modifiable influences are:
Saturated Fat Intake
The primary dietary driver of elevated LDL. Found in butter, ghee, full-fat dairy, fatty meat, processed meat, pastry, biscuits, coconut oil, and palm oil. Replacing saturated fat with unsaturated fat — olive oil, avocado, nuts, oily fish — is the single most evidence-based dietary intervention for LDL reduction.
Physical Inactivity
Regular aerobic exercise raises HDL and lowers triglycerides. The NHS recommends 150 minutes of moderate aerobic activity per week as a minimum for cardiovascular health.
Body Weight
Excess weight, particularly abdominal fat, is associated with elevated triglycerides and low HDL. Weight reduction of 5 to 10% of body weight produces measurable improvements in the lipid profile.
Alcohol
Raises triglycerides significantly and, at high intake, contributes to elevated total cholesterol. The NHS recommends no more than 14 units per week.
Smoking
Lowers HDL and damages arterial walls, compounding the cardiovascular risk from elevated LDL. Smoking cessation is one of the most impactful cardiovascular risk reduction interventions available.
Genetics
Familial hypercholesterolaemia (FH) is an inherited condition affecting approximately 1 in 250 people in the UK, causing significantly elevated LDL from birth. FH cannot be fully managed through lifestyle alone and requires lipid-lowering medication.
Other Medical Conditions
Hypothyroidism, type 2 diabetes, kidney disease, and liver disease can all raise cholesterol. Secondary causes should be excluded before attributing elevated cholesterol to primary dyslipidaemia.
A patient who came to The Private GP Birmingham for a full cholesterol blood test — a woman in her late forties — had a total cholesterol of 6.2 mmol/L. Her LDL was 4.1 mmol/L and her HDL was 1.6 mmol/L. On first glance, her total cholesterol and LDL were both above their respective targets. But Dr Ul-Haq also noted her TSH was elevated at 7.8 mIU/L — indicative of hypothyroidism, which commonly drives secondary hypercholesterolaemia. Rather than initiating a statin, Dr Ul-Haq commenced levothyroxine for the hypothyroidism. At her three-month review, having achieved a euthyroid TSH of 1.9 mIU/L, her LDL had fallen to 3.2 mmol/L and her total cholesterol to 5.4 mmol/L — still above ideal, but meaningfully improved without lipid-lowering medication. The cholesterol result had prompted the investigation that found the real diagnosis. Treating the cause, not the cholesterol number, produced the better clinical outcome.
A Quick Reference: Good Cholesterol Levels in the UK at a Glance
- Total cholesterol (healthy adult): below 5.0 mmol/L
- Total cholesterol (after heart attack/stroke): below 4.0 mmol/L
- LDL cholesterol (primary prevention): below 3.0 mmol/L
- LDL cholesterol (secondary prevention): 0 mmol/L or below (NICE NG238)
- HDL cholesterol (women): above 1.2 mmol/L
- HDL cholesterol (men): above 1.0 mmol/L
- Non-HDL cholesterol (primary prevention): below 4.0 mmol/L
- Non-HDL cholesterol (secondary prevention): 6 mmol/L or below (NICE NG238)
- Triglycerides (fasting): below 1.7 mmol/L
If you would like to know where your cholesterol levels stand against these targets, a private cholesterol blood test at The Private GP Birmingham provides the full fasting lipid panel — total cholesterol, LDL, HDL, non-HDL, and triglycerides — with same-day results and a face-to-face results review with Dr Israar Ul-Haq. He will calculate your QRISK3 cardiovascular risk score, contextualise your results within your full health picture, and advise on whether lifestyle modification, monitoring, or treatment is the most appropriate next step. Same-day appointments are available — no referral required. If you would like your cholesterol assessed as part of a broader cardiovascular and metabolic health screen, our comprehensive private blood test service covers all relevant markers in a single appointment.
Frequently Asked Questions
- What is a good total cholesterol level in the UK?
The NHS and British Heart Foundation recommend a total cholesterol level below 5.0 mmol/L for healthy adults as a general target. If you have already had a heart attack or stroke, the target is lower — below 4.0 mmol/L. However, total cholesterol alone is not the most clinically informative figure. Your LDL, HDL, non-HDL cholesterol, and triglycerides — interpreted alongside your QRISK3 cardiovascular risk score — give a much more complete picture of your actual cardiovascular risk than total cholesterol alone.
- What is a good LDL cholesterol level in the UK?
For healthy adults without established cardiovascular disease (primary prevention), the UK target for LDL cholesterol is below 3.0 mmol/L. For people who have already had a heart attack, stroke, or have established cardiovascular disease (secondary prevention), NICE NG238 sets an LDL target of 2.0 mmol/L or below — a more intensive target reflecting the higher risk in this group. For those on lipid-lowering treatment for primary prevention, the treatment response aim is a greater than 40% reduction in non-HDL cholesterol from baseline.
- What is a good HDL cholesterol level in the UK?
A good HDL cholesterol level is above 1.2 mmol/L for women and above 1.0 mmol/L for men (British Heart Foundation guidance). HDL is the protective form of cholesterol — it carries cholesterol away from the arteries — so higher is generally better, up to around 1.4 mmol/L. Low HDL (below 1.0 mmol/L in women, below 0.9 mmol/L in men) is an independent cardiovascular risk factor and is particularly significant when combined with elevated LDL or triglycerides.
- What is a good non-HDL cholesterol level in the UK?
Non-HDL cholesterol — total cholesterol minus HDL — should ideally be below 4.0 mmol/L for healthy adults without cardiovascular disease (primary prevention target). For those with established cardiovascular disease, NICE NG238 sets a secondary prevention target of 2.6 mmol/L or below. Non-HDL cholesterol is NICE’s preferred primary prevention treatment target because it captures all atherogenic lipoproteins in a single figure and does not require a fasting blood sample to be accurate.
- How do I find out if my cholesterol levels are good?
The only reliable way to know your cholesterol levels is through a blood test. At The Private GP in Birmingham, a private cholesterol blood test provides the full fasting lipid panel — total cholesterol, LDL, HDL, non-HDL, and triglycerides — with a face-to-face GP results review by Dr Israar Ul-Haq. He will interpret your results against current UK targets, calculate your QRISK3 cardiovascular risk score, and advise on next steps specific to your individual risk profile. Same-day appointments are available. If you would prefer a broader health assessment, our private blood test service covers cholesterol alongside thyroid function, HbA1c, kidney and liver function, and more in a single appointment.