ARTICLE

Cholesterol Index Guide: Understand the Cholesterol Levels Chart, High Cholesterol Thresholds and Protection Considerations

12-min read

Updated on 2026-9-25

Author: AIA Content Editorial Team

A smiling young Asian woman is enjoying freshly made delicious burger with fries and a glass of iced coffee in a café.

High cholesterol usually causes no obvious symptoms, but it may increase the risk of ischaemic cardiovascular diseases such as coronary heart disease and stroke. If an acute condition occurs, surgery, follow-up consultations and rehabilitation may create additional medical expenses for individuals and families. Understanding your Cholesterol Index, referring to a Cholesterol Levels Chart and knowing the high cholesterol thresholds can help you manage blood lipid levels and reduce the risk of sudden cardiovascular events.

What Is Cholesterol? Understanding "Good" and "Bad" Cholesterol

Cholesterol is an essential lipid in the human body. It is mainly produced by the liver and is needed to form cell membranes, synthesise hormones such as sex hormones, and produce vitamin D. However, cholesterol must bind with lipoproteins before it can travel through the bloodstream. The type of lipoprotein involved determines how it affects cardiovascular health.¹

Low-density lipoprotein (LDL) —— "bad cholesterol": LDL mainly transports cholesterol from the liver to cells throughout the body. When the LDL level in the blood is too high, excess cholesterol may accumulate on the inner walls of blood vessels. Over time, this can form atherosclerotic plaques, narrowing or even blocking the blood vessels.
High-density lipoprotein (HDL) ——"good cholesterol": HDL functions like a cleaning system within the blood vessels. It collects excess cholesterol from the bloodstream and carries it back to the liver, where it is metabolised and removed from the body. This process helps protect vascular health.
Triglycerides (TG)²: Although triglycerides are not cholesterol, they are another important type of fat found in the blood. They are mainly produced from sugars and fats in the daily diet and are used to store energy. High triglyceride levels are commonly associated with obesity and diabetes and may also increase cardiovascular risk.

In addition to LDL and HDL, the blood also contains very-low-density lipoprotein (VLDL).³VLDL is mainly responsible for transporting triglycerides. After releasing triglycerides, VLDL is metabolised into intermediate-density lipoprotein (IDL) and then LDL. Some LDL particles may become highly atherogenic small, dense LDL particles, or sdLDL, which can further accelerate the hardening of blood vessels. Controlling triglycerides is therefore not only about reducing the storage of excess energy. It may also help reduce VLDL particles that can potentially damage blood vessels.

What Level Is Considered High? Cholesterol Levels Chart and High Cholesterol Thresholds (Unit: mmol/L)

Assessing cardiovascular risk requires more than looking at total cholesterol alone. The proportions and levels of the different blood lipid indicators must also be considered.

According to the Centre for Health Protection, the following Cholesterol Levels Chart may be used as a general reference.¹

Test Item	Desirable Level (mmol/L)	Borderline High (mmol/L)	High-Risk Level (mmol/L)
Total cholesterol	< 5.2	5.2 - 6.1	≥ 6.2
Low-density lipoprotein (LDL, or bad cholesterol)	< 3.4	3.4 - 4.1	≥ 4.1
High-density lipoprotein (HDL, or good cholesterol)	> 1.0 for men / > 1.3 for women	1.0 - 1.5	< 1.0 for men / < 1.3 for women

Note: The figures above are intended only as a general reference for adults. A diagnosis should be made by a registered doctor based on the individual's health condition.

In general, lower levels of bad cholesterol are considered preferable. According to guidelines from the European Society of Cardiology, the LDL treatment target for people at very high risk, including those with cardiovascular disease or diabetes, should be tightened to below 1.4 mmol/L.⁴ This may help stabilise atherosclerotic plaques within the blood vessels.

Potential Health Risks of Exceeding the Recommended Cholesterol Index

When cholesterol remains high over an extended period, plaque accumulation may cause the blood vessels to lose elasticity, resulting in atherosclerosis. If a plaque ruptures and forms a blood clot, it may create an immediate threat to life:

Coronary heart disease: Narrowed blood vessels may reduce blood flow to the heart muscle and cause angina, or chest pain. A complete blockage may result in an acute myocardial infarction.
Cerebrovascular disease: A blockage in the carotid arteries or cerebral blood vessels may cause an ischaemic stroke, potentially resulting in permanent impairment of mobility or cognitive function.

Cardiovascular emergencies require urgent treatment. In critical circumstances, patients may choose to undergo percutaneous coronary intervention, commonly referred to in Hong Kong as "Coronary Angioplasty", at a private hospital to receive treatment as quickly as possible. Based on charges at private hospitals in Hong Kong, a single percutaneous coronary intervention procedure, including hospitalisation and miscellaneous fees, may cost approximately HK$140,000 to HK$160,000.⁵

To prepare for unexpected medical expenses, individuals may consider their personal needs, existing protection and budget when learning about options such as Voluntary Health Insurance Scheme plans or Critical Illness Insurance covering heart disease. Such protection may help reduce the financial impact of related medical expenses on individuals and their families.

Key Factors Affecting Cholesterol Levels

Understanding the causes of abnormal cholesterol levels can help identify appropriate management measures.

Diet and body weight: Regular consumption of foods high in saturated fat, such as red meat and full-fat dairy products, and trans fats, such as fried foods and pastries, is a major factor that can raise bad cholesterol.¹ Being overweight may also lower good cholesterol levels.
Age and sex: The risk of abnormal blood lipid levels and elevated bad cholesterol increases with age. After menopause, women may experience a significant rise in bad cholesterol as the protective effects of oestrogen decline.⁶
Family history and genetics: Some people have familial hypercholesterolaemia, a genetic condition in which mutations prevent the liver from effectively removing LDL from the bloodstream.⁷
Chronic diseases: Diabetes, hypothyroidism and kidney disease may interfere with lipid metabolism and affect cholesterol levels.

Some people mistakenly assume that being slim means having normal blood lipid levels. However, thin people can also have high cholesterol.⁸ A person carrying a gene associated with inherited high cholesterol may still have severely elevated LDL levels despite following a light diet and having a slim physique. Regular blood tests are the most reliable way to accurately understand an individual's blood lipid profile.

How to Lower Cholesterol

Cholesterol can be managed by making changes to everyday habits and, where necessary, combining these measures with medical treatment.

1. Dietary Adjustments⁹

Increase soluble fibre intake: Foods such as oats, beans, apples and chia seeds can help reduce the absorption of cholesterol in the intestines.
Choose unsaturated fats: Replace animal fats with olive oil or avocado. Eating oily deep-sea fish, such as salmon and mackerel, at least twice a week can provide omega-3 fatty acids and may help lower triglycerides.
Avoid trans fats: Reduce the consumption of processed foods containing hydrogenated vegetable oils. Trans fats may raise bad cholesterol while lowering good cholesterol.

2. Regular Exercise and Healthy Lifestyle Habits¹

Aerobic exercise: Completing at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking or swimming, can help raise HDL, or good cholesterol, levels.
Quit smoking: Smoking damages the inner lining of blood vessels and accelerates cholesterol accumulation. Research has also found that good cholesterol levels generally improve after a person stops smoking.

3. Medication

If the Cholesterol Index remains outside the recommended range after several months of lifestyle changes, or if the individual is at high risk of cardiovascular disease, a doctor may prescribe medication. Statins, one of the most commonly used types of cholesterol-lowering medication, work by limiting cholesterol production in the liver.¹⁰ Medication must be prescribed by a doctor. Patients should not stop taking their medication or adjust the dosage without medical advice.

About Cholesterol Index FAQs

Usually, there are no symptoms during the early stages. High cholesterol is sometimes described as a "silent killer"² because many people do not realise that their blood vessels are severely blocked until they develop angina or experience a stroke.

Adults, particularly those over the age of 40 or with a family history of high cholesterol, are therefore advised to undergo regular blood tests.

Yes. Cholesterol levels are influenced not only by diet, but also by liver metabolism and genetic factors, such as familial hypercholesterolaemia. Even people with a slim physique may still have high LDL (bad cholesterol) levels if their body is unable to process and remove cholesterol effectively. Regular blood tests remain the most reliable way to assess an individual's cholesterol profile.

Regular moderate-intensity aerobic exercise, such as brisk walking and cycling, may help increase good cholesterol. Quitting smoking may also significantly improve HDL cholesterol levels and the overall elasticity of blood vessels.¹

This depends on how well the individual's cholesterol is controlled, whether cardiovascular complications have developed, their overall health condition, and the underwriting decision of the relevant insurance company.

The underwriting result will depend on the individual's detailed health declaration and medical reports. AIA offers various Medical Protection and Critical Illness Protection options. Individuals may make further enquiries and consider the available options according to their medical needs and budget.

^{The above information is for Hong Kong and/ or Macau only. The content contains general information only and shall not constitute, nor be construed as, any sales advice, investment or insurance advice, product recommendation, solicitation and/or offer of services. This information does not take into account any person's financial situation or needs, and should not be relied upon as the sole basis for making any financial, investment or insurance decision. Customer must complete the Financial Needs Analysis before applying for any insurance product. The product information on this website is for reference only and does not contain the full terms of the product. For details of the product features, terms and conditions, exclusions and key product risks, please refer to the relevant product brochure and policy contract of the relevant products. In case you want to read a sample of the policy contract before making an application, you can obtain a copy from AIA. Life insurance policies are long-term contracts of insurance. Should you surrender the policy early, you may receive an amount considerably less than the total amount of premiums paid. AIA does not guarantee the accuracy or completeness of the content and information contained herein. AIA shall not assume any liability in respect of the content, services and/or products referred to in this information.

This article is owned by AIA, and may not be copied or reproduced without AIA's written consent. You may not copy or store this content on any other website or content platform. AIA reserves the absolute discretion to suspend or remove this article at any time without prior notice. In the event of any infringement and/or legal issues, AIA reserves the right to take appropriate legal action and seek compensation.}

^{This information is general information and for reference only, and should not be considered as a medical, diagnosis or professional recommendation, and cannot replace any medical, diagnosis or professional recommendation from doctors. Independent professional advice should be sought from an appropriate qualified medical professional (such as doctors) before making any decision on the topics mentioned above. Treatment may vary according to individual circumstances. If in doubt, you may ask your doctor. If necessary, you may seek other medical advice as soon as possible and do not ignore or delay seeking medical advice / treatment. AlA assumed no liability for any loss or damage arising directly or indirectly from the use, misuse, understanding or application of any of the above information.}

^1.Centre for Health Protection, Department of Health, Hong Kong SAR Government. https://www.chp.gov.hk/files/her/exnnutp036_en.pdf, online source, accessed 19 June 2026.

^2.Nu Skin, https://www.nuskin.com/zh_HK/cholesterol-causes-symptoms-treatments-cholestin.html, online source, accessed 19 June 2026.

^3.HelloYishi，https://helloyishi.com.tw/heart-health/cholesterol/what-is-chlesterol/, online source, accessed 19 June 2026.

^4.The Society of Hospital Pharmacists of Hong Kong, https://www.derc.org.hk/en/perspective-detail.php?id=142, online source, accessed 19 June 2026.

^5.Hong Kong Adventist Hospital, https://www.hkah.org.hk/en/promotions/percutaneous-coronary-intervention-pci-subsidy-scheme, online source, accessed 19 June 2026.

^6.The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, https://www.nur.cuhk.edu.hk/in-the-press/20200711-hkej/, online source, accessed 19 June 2026.

^7.The Society of Hospital Pharmacists of Hong Kong, https://www.derc.org.hk/en/perspective-detail.php?id=70, online source, accessed 19 June 2026.

^8.St. Paul's Hospital, https://www.stpaul.org.hk/en/health-corner/detail/%E7%98%A6%E4%BA%BA%E9%83%BD%E6%9C%89%E6%A9%9F%E6%9C%83%E8%86%BD%E5%9B%BA%E9%86%87%E9%81%8E%E9%AB%98-%E5%BF%BD%E8%A6%96%E6%81%90%E5%BC%95%E7%99%BC%E5%BF%83%E8%87%9F%E5%8D%B1%E6%A9%9F-%E6%9B%BE%E5%8D%93%E6%81%92%E9%86%AB%E7%94%9F-%E8%81%96%E4%BF%9D%E7%A5%BF%E9%86%AB%E9%99%A2%E5%BF%83%E8%87%9F%E7%A7%91%E5%B0%88%E7%A7%91, online source, accessed 19 June 2026.

^9.Diabetes Hongkong, https://diabetes-hk.org/8-ways-to-lower-cholesterol/, online source, accessed 19 June 2026.

^10.Sha Tin District Health Centre Express,, https://www.stdhc.org.hk/express/dyslipidemia-meds/, online source, accessed 19 June 2026.

You may also be interested in

Article

Lymphadenopathy: What Do Swollen Lymph Nodes in the Neck Mean? Common Symptoms and Warning Signs

13-min

Article

Colorectal Cancer Prevention Guide: Early Symptoms and Screening

14-min

Article

Critical Illness Insurance Definition: A Comprehensive Guide & 3 Reasons Why You Need Coverage in Hong Kong

13-min

Recommendation on product categories

On Your Side Insurance Plan 2 / On Your Side Insurance Plan 2 - First Gift

With love and care, from the first step to every step

AIA Voluntary Health Insurance SelectWise Scheme

Sustainable and Affordable Protection for You

ProsperLife Insurance Plan

Your lifelong shield, your peace of mind

Contact us now

^{*Required fields}

Are you an existing customer?*

No Yes

Policy number (optional)

First Name*
Last Name*
What's your phone number?*
What's your email?*
Preferred Contact Method*
Preferred Language*

I agree to the relevant AIA Entity's use of my personal data for the above purposes in accordance with the Personal Information Collection Statement. I further consent to the relevant AIA Entity's use of my personal data provided above for the AIA Entity's financial planner to contact me.

Additional Info

campID

campName

Date of birth

PlanCode

ProdName

Contact us now

^{*Required fields}

Are you an existing customer?*

No Yes

Policy number (optional)

First Name*
Last Name*
What's your phone number?*
What's your email?*
Preferred Contact Method*
Preferred Language*

I agree to the relevant AIA Entity's use of my personal data for the above purposes in accordance with the Personal Information Collection Statement. I further consent to the relevant AIA Entity's use of my personal data provided above for the AIA Entity's financial planner to contact me.

Additional Info

campID

campName

Date of birth

PlanCode

ProdName

Cholesterol Index Guide: Understand the Cholesterol Levels Chart, High Cholesterol Thresholds and Protection Considerations

What Is Cholesterol? Understanding "Good" and "Bad" Cholesterol

What Level Is Considered High? Cholesterol Levels Chart and High Cholesterol Thresholds (Unit: mmol/L)

Potential Health Risks of Exceeding the Recommended Cholesterol Index

Key Factors Affecting Cholesterol Levels