Cholesterol Goal Calculator

Cholesterol goals are not one-size-fits-all. Guidelines set different LDL (Low-Density Lipoprotein) targets depending on how much cardiovascular risk you carry, and the same number that is perfectly fine for one person is a treatment trigger for another.

Which guidelines these numbers come from. Two sets agree on most of them. The European ESC/EAS 2019 guideline has used fixed LDL goals for years. The American ACC/AHA guideline used to work differently, asking for a percentage cut rather than a number, but its 2026 replacement, released in March, brought absolute goals back. The two now line up on 55, 70 and 100 mg/dL. They part company only at low risk, where Europe sets a goal of 116 mg/dL and the American guideline sets none and leans on lifestyle instead.

Why LDL matters:

LDL, the one usually called “bad cholesterol”, is a primary driver of atherosclerosis, the plaque buildup in arteries behind most heart attacks and strokes. Lower is better across the whole range studied. How far down you need to go is what depends on your risk profile.

Risk categories and LDL targets:

Very High Risk (LDL goal: below 55 mg/dL or 1.4 mmol/L)
Includes: a prior heart attack or stroke, or other diagnosed artery disease. The American guideline keeps this band for artery disease plus further risk factors, such as diabetes, kidney disease or a second event; in Europe the diagnosis alone puts you here. Both set 55.

High Risk (LDL goal: below 70 mg/dL or 1.8 mmol/L)
Includes: in the US, diagnosed artery disease without those extra factors. In both, no diagnosis but a high 10-year risk, 10% or more on the American PREVENT calculator. In Europe this band also takes diabetes of 10 years or more, moderate chronic kidney disease and familial hypercholesterolaemia.

Moderate Risk (LDL goal: below 100 mg/dL or 2.6 mmol/L)
Includes: no diagnosed artery disease and a 10-year risk of 3% to under 10%. The 2026 American guideline also puts most adults aged 40 to 75 with diabetes here.

Low Risk (LDL goal: below 116 mg/dL or 3.0 mmol/L in Europe)
Includes: a 10-year risk under 3% and no diagnosed artery disease. The American guideline gives no number at this level and asks for lifestyle optimisation instead.

The risk percentages come from a calculator your doctor runs, PREVENT in the US and SCORE2 in Europe, not from counting risk factors at home. The two tools do not measure quite the same thing, so a risk band can differ between them for the same person.

For the high and very high bands, the European guideline also asks for the LDL to come down by at least half from where it started before treatment. Hitting 69 from 80 meets the number and misses that.

Understanding your numbers:

Total cholesterol, HDL (“good” cholesterol), and triglycerides all matter alongside LDL. HDL above 60 mg/dL is protective. Triglycerides below 150 mg/dL is ideal. The 2026 American guideline also recommends measuring lipoprotein(a) once in adulthood, because a high level is inherited and raises risk whatever the LDL.

Always discuss your specific targets with your doctor. This calculator provides educational guidance only.