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Cardiovascular

LDL cholesterol: what a value that is too high does to the vessel wall, and the target values

According to the NVKC, the Dutch society of clinical chemists, LDL is a type of lipoprotein, a fat droplet of cholesterol, triglycerides and proteins in the blood, that carries cholesterol to the tissues and organs. According to the NVKC, cholesterol plays an important role in building tissues and organs and in making certain hormones and bile acids.

According to the NVKC, raised LDL cholesterol concentrations are undesirable, because they cause cholesterol to be deposited on the walls of the blood vessels; this can lead to a stiff vessel wall, reduced blood flow and even blockage, and so to cardiovascular disease. According to Thuisarts, the Dutch GPs' patient site, high cholesterol causes no symptoms, so only a blood test shows the LDL.

Unilabs uses 0 to 4.5 mmol/l for LDL cholesterol. Diagnostiek voor U uses a target value below 2.6 mmol/L for people older than 18 and below 1.8 mmol/L for high-risk groups, and Star-SHL gives 0 to 2.5 mmol/l with the Dutch GPs' cardiovascular risk management guideline (NHG) as its source.

The route LDL Cholesterol takes through your body
  1. Liver

    Sends cholesterol out to the rest of your body.

  2. LDL, the package

    Cholesterol is fatty and does not dissolve in blood, so it travels packed. The test counts what is inside these packages.

  3. Your cells

    Take what they need to build their wall and to make hormones.

  4. What the cells do not take up stays in your blood

  5. Artery wall

    The surplus works its way in, builds up over the years and narrows the artery. That can end in a heart attack or a stroke.

General target below 3 mmol/l

Doctor's Assessment Included

LDL cholesterol is the cholesterol in the LDL particles, which carry cholesterol to the tissues and organs. According to the NVKC, raised concentrations make cholesterol deposit on the vessel wall, which can lead to cardiovascular disease.

  • The NVKC gives a target value for LDL cholesterol below 3.0 mmol/l; Thuisarts calls below 2.6 usually good at a high risk of cardiovascular disease and below 1.8 at a very high risk.
  • For LDL cholesterol, Unilabs uses 0 to 4.5 mmol/l, Diagnostiek voor U a target below 2.6 mmol/L above age 18, Star-SHL 0 to 2.5 mmol/l (source NHG).
  • According to Thuisarts, a high LDL cholesterol causes no symptoms.

When is this value abnormal?

Decision limits per result, in mmol/l
Result Value (mmol/l)
Below target < 3
Above target 3–5
Markedly elevated ≥ 5

There is no single "normal" LDL value: which value is desirable for you depends on your overall risk of cardiovascular disease. The limit of 3.0 mmol/l is the general target value of the NVKC. Once there is a reason to treat, the NHG guideline CVRM uses a lower target: < 2.6 mmol/l, and < 1.8 mmol/l after cardiovascular disease, up to and including age 70. For people at low to moderately raised risk, the guideline sets no target at all, and lifestyle advice is enough. Above 5.0 mmol/l the NHG advises considering familial dyslipidaemia. Discuss your result with your GP.

Source: NVKC Reference population: Dutch adults

Source: NHG Reference population: Dutch adults

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

LDL Cholesterol: what Dutch laboratories use

The upper limit runs from 2.5 mmol/l at Star-shl to 4.5 mmol/l at Unilabs.

Reference ranges by group, in mmol/l
Star-shl · Everyone · a limit, not a range · Source: NHG cardiovascular risk management < 2.5 mmol/l
2.5
Unilabs · Everyone 0.0–4.5 mmol/l
0 4.5
Diagnostiek voor U · Everyone · 19 years and older · a limit, not a range · target value < 2.6 mmol/L
2.6
Diagnostiek voor U · Everyone · a limit, not a range · high-risk groups < 1.8 mmol/L
1.8
0 4.95 mmol/l

Source: Star-shl

Source: Unilabs

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

LDL Cholesterol: what this test measures

According to the NVKC, the LDL cholesterol test measures the amount of LDL cholesterol in the blood, in millimoles per litre (mmol/l). Star-SHL calculates LDL cholesterol within the lipid group (code BC26) or measures it (code LDLD); Unilabs measures it directly. According to the NVKC, LDL cholesterol forms the lipid profile together with total cholesterol, HDL cholesterol and triglycerides.

LDL Cholesterol: why this value matters

LDL cholesterol matters because, according to the NVKC, of all forms of cholesterol it is regarded as the most important risk factor for causing cardiovascular disease. According to the NVKC, the doctor often decides on the basis of a raised LDL cholesterol to treat someone with cholesterol-lowering medicines or to adjust the treatment. According to Thuisarts, when cholesterol is too high for years the risk of a disease of the heart and blood vessels is greater, although not everyone with high cholesterol gets such a disease.

LDL Cholesterol: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Heart checkup · €209,- · General checkup · €199,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

LDL Cholesterol: how to prepare

Nothing special is needed for these tests.

  1. No need to fast

    Good to know

    Eating beforehand makes little difference to these values. You can have breakfast.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

LDL Cholesterol: when is testing worthwhile?

According to the NVKC, the LDL cholesterol test is used to estimate the risk of cardiovascular disease and to measure the effect of cholesterol-lowering medicines or diets, usually together with total cholesterol. According to the NVKC, for a good risk estimate it is important that the blood is taken fasting, without eating or drinking in the 12 hours before, because LDL and triglycerides in particular are strongly influenced by food.

LDL Cholesterol: symptoms of a high or low value

Low Levels

The sources read describe a low LDL cholesterol only as a result of treatment: according to MedlinePlus, LDL can fall with cholesterol-lowering medicines such as statins, and losing weight when overweight can help lower LDL. According to the NVKC the target value is below 3.0 mmol/l, and Thuisarts calls an LDL below 1.8 usually good for a very high risk of a disease of the heart and blood vessels.

High Levels

According to Thuisarts, a high LDL cholesterol causes no symptoms, but cholesterol that is too high for years increases the risk of, among others, chest pain, kidney damage, intermittent claudication, a heart attack and a stroke. According to MedlinePlus, LDL rises with saturated fat and cholesterol in the diet, being overweight tends to raise LDL, and certain medicines and diseases such as chronic kidney disease, diabetes and HIV can raise LDL. According to MedlinePlus, high cholesterol can also run in families, as in familial hypercholesterolaemia, an inherited form.

LDL Cholesterol: causes of a low or high value

What lowers the value

  • Cholesterol-lowering medicines, such as statins

    If lifestyle changes alone do not lower LDL enough, cholesterol-lowering medicines, including statins, may be needed.

  • Losing weight when overweight

    If someone is overweight, losing weight can help lower the amount of LDL cholesterol in the blood.

What raises the value

  • Saturated fat and cholesterol in food

    Saturated fat and cholesterol in the food you eat make your LDL level rise.

  • Overweight

    Being overweight tends to raise the LDL cholesterol level and to lower the HDL cholesterol level.

  • Inherited high cholesterol (familial hypercholesterolaemia)

    High cholesterol can run in families; familial hypercholesterolaemia is an inherited form of high blood cholesterol.

  • Certain medicines, such as steroids

    Certain medicines, including steroids, some blood pressure medicines and HIV medicines, can raise LDL.

  • Chronic kidney disease, diabetes or HIV

    Diseases such as chronic kidney disease, diabetes and HIV can cause a higher LDL.

LDL Cholesterol: lifestyle and this value

According to Thuisarts, a high LDL cholesterol can come down with healthy living: stopping smoking, eating and drinking healthily, moving enough, not sitting too much, losing weight when overweight, not drinking alcohol and reducing stress. According to Thuisarts, medicines are sometimes needed too, and high cholesterol does not go away by itself. Discuss a raised LDL with your GP.

LDL Cholesterol: frequently asked questions

What is a normal LDL cholesterol?

According to the NVKC, in most healthy people LDL cholesterol lies between 2.0 and 4.5 mmol/l, but according to the NVKC the target value is below 3.0 mmol/l. Thuisarts calls an LDL below 3 usually good in healthy people who take no medicines.

Do I need to fast for an LDL cholesterol test?

According to the NVKC, fasting blood is important for a good risk estimate when the blood fats are tested, because LDL and triglycerides in particular are strongly influenced by food; fasting means not eating or drinking for 12 hours.

LDL Cholesterol: sources

  1. Nederlandse Vereniging voor Klinische Chemie en Laboratoriumgeneeskunde. Alles over testen. Over AFP: "De referentiewaarden kunnen verschillen tussen laboratoria, afhankelijk van de methode. Ga daarom uitsluitend af op de referentiewaarden van het laboratorium dat het onderzoek heeft uitgevoerd en interpreteer nooit AFP-uitslagen van verschillende laboratoria door elkaar." Geraadpleegd 14 juli 2026. (retrieved 2026) allesovertesten.nl
  2. Nederlands Huisartsen Genootschap. NHG-Standaard Cardiovasculair risicomanagement. Praktische handleiding, 2024. Geraadpleegd 14 juli 2026. (retrieved 2026) richtlijnen.nhg.org
  3. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  4. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. MedlinePlus, LDL: The "Bad" Cholesterol, medlineplus.gov, geraadpleegd 2026-10-17 (retrieved 2026) medlineplus.gov

Test Products

This marker is included in the following test panels.

Heart & vessels

Heart checkup

An extensive blood test with 12 heart and vessel values — the full cholesterol profile, Apo(B), Lp(a), hsCRP, homocysteine and blood sugar — for insight into your heart and vessel health.

Total Cholesterol LDL Cholesterol HDL Cholesterol Non-HDL Cholesterol Cholesterol/HDL Ratio Triglycerides ApoB (Apolipoprotein B) Lipoprotein(a) hs-CRP (High Sensitivity CRP) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Creatinine eGFR (Estimated Glomerular Filtration Rate) LDL/HDL Ratio
€209,-
General checkup

General checkup

A broad blood test covering 18 values across liver, kidneys, thyroid, heart, vitamins and blood count.

ALT (Alanine Aminotransferase) GGT (Gamma-Glutamyl Transferase) Creatinine eGFR (Estimated Glomerular Filtration Rate) TSH (Thyroid Stimulating Hormone) Total Cholesterol HDL Cholesterol LDL Cholesterol Triglycerides Glucose (Fasting) Vitamin D (25-OH) Vitamin B12 Ferritin Hemoglobin Leukocytes (WBC) Platelets (Thrombocytes) CRP (C-Reactive Protein) MCV (Mean Corpuscular Volume) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€199,-

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
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LDL Cholesterol

€16,-