Cholesterol: LDL, non-HDL and apoB, which target counts?

This is general information, not medical advice. Always discuss your blood values with your doctor.

1. 1

   First: what does your blood test measure?

   A standard lipid profile gives total cholesterol, LDL, HDL and triglycerides. Non-HDL cholesterol is a simple sum: total cholesterol minus HDL. It includes all the cholesterol in particles that can damage the vessel wall, not just LDL.

2. 2

   The European targets by risk profile

   The ESC/EAS guideline links the target to your risk. Very high risk: LDL below 1.4 mmol/L (55 mg/dL) and non-HDL below 2.2 mmol/L (about 85 mg/dL). High risk: below 1.8 (70) and 2.6 (100). Moderate risk: below 2.6 (100) and 3.4 (130). Low risk: below 3.0 (116) and 3.8 (145). For high and very high risk, a reduction of at least 50% from your baseline is also expected. For moderate and low risk these are values that “may be considered”. The 2025 update left the targets unchanged.

3. 3

   Who counts as “high risk” is decided by your doctor

   Your doctor estimates that risk with the SCORE2 models (age, sex, blood pressure, smoking and cholesterol). Your category can be very different from that of someone with diabetes or cardiovascular disease. A total cholesterol of 5 mmol/L (about 190 mg/dL) or more is a reason to look for other risk factors. If your LDL is above 4.9 mmol/L (190 mg/dL), ask about familial hypercholesterolaemia, an inherited condition.

4. 4

   Why non-HDL and apoB are often better than LDL alone

   LDL only measures the cholesterol inside LDL particles. A meta-analysis of epidemiological studies (Sniderman et al., 2011) found that apoB, which reflects the number of harmful particles, predicted risk best (standardised risk ratio 1.43), ahead of non-HDL (1.34) and LDL (1.25). In people on statins, non-HDL predicted risk better than LDL (Boekholdt et al., JAMA 2012). A 2025 systematic review concludes that apoB remains more accurate than LDL and non-HDL when they disagree. That matters most with high triglycerides, overweight and diabetes, where the ESC explicitly recommends non-HDL.

Updated in October 2026