LDL is the cholesterol that can build up in artery walls. In the US, LDL of 160–189 mg/dL is classed as high and 190 or more as very high; 160 mg/dL is about 4.1 mmol/L in UK units, where the NHS suggests 3 mmol/L or less for healthy adults. How much your LDL matters depends on your overall risk, which your doctor estimates with a calculator, not on the number alone.
| Category | Reference range |
|---|---|
| Optimal | below 100 (below 2.6) mg/dL (mmol/L in brackets) |
| Near optimal | 100–129 (2.6–3.3) mg/dL (mmol/L in brackets) |
| Borderline high | 130–159 (3.4–4.0) mg/dL (mmol/L in brackets) |
| High | 160–189 (4.1–4.8) mg/dL (mmol/L in brackets) |
| Very high | 190 or more (4.9 or more) mg/dL (mmol/L in brackets) |
US categories (NHLBI); NHS guide for healthy adults: 3.0 mmol/L or less. Personal targets are lower if you have heart disease, diabetes or other risks. mmol/L × 38.7 = mg/dL.
LDL particles carry cholesterol to the tissues. When there are too many for too long, cholesterol is deposited in the artery walls, forming plaques that narrow arteries and can trigger heart attacks and strokes. The risk builds over decades, so both the level and how many years it has been high matter.
High LDL does not cause symptoms. It is found only on a blood test, which is why lipid checks are offered routinely to adults, in the UK as part of the NHS Health Check from 40.
Yes, it is in the high category by US standards and clearly above the NHS guide. For a 35-year-old woman who does not smoke, with normal blood pressure, the 10-year risk may still be low, and lifestyle changes are usually the first step. For a 60-year-old man with diabetes or high blood pressure, the same LDL carries far more weight.
Doctors in the UK use QRISK3 and in the US the ASCVD or PREVENT risk calculators. Whether medication is discussed depends on that overall result and on your preferences; your doctor will explain the options.
A high HDL is generally favourable, but it does not cancel out a high LDL: very high LDL still adds risk. Some people, often women or people who exercise a lot, have both high HDL and high LDL; the decision is still based on overall risk.
High LDL with low triglycerides is a common pattern in people on low-carbohydrate diets, and also in inherited high cholesterol. Very high LDL (190 mg/dL / 4.9 mmol/L or above) in a young person, with a family history of early heart disease, may point to familial hypercholesterolaemia, which affects about 1 in 250 people and can be tested for in specialist clinics.
Discuss a high LDL with your GP or doctor at a routine appointment; they will usually repeat the test and calculate your risk. Book sooner if:
Written using public information from:
No need to decode the numbers yourself: take a photo of the report and the app explains “High LDL cholesterol” and the rest in plain words — what is normal and what deserves attention.
App StoreGoogle PlayWeb versionYes. In the US, 160 to 189 mg/dL is classed as high. In UK units it is about 4.1 mmol/L, above the NHS guide of 3 mmol/L. What it means for you depends on your overall cardiovascular risk.
About 159 mg/dL. Multiply mmol/L by 38.7 to get mg/dL, or divide mg/dL by 38.7 to get mmol/L.
No. It depends on your overall risk, age, other conditions and your preferences. Many people start with diet and activity changes; others benefit from medication. This is a decision to make with your doctor.
High HDL is generally a good sign, but it does not fully offset high LDL. Your doctor will still look at your LDL and your overall risk score.
No. It is silent until it contributes to a problem such as a heart attack or stroke, which is why routine blood tests matter.
This material is for general information only. It is not a medical opinion and does not replace a consultation with a doctor. Reference ranges depend on the laboratory and the method — rely on the range printed on your own report. Your doctor makes the final interpretation.
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