ObjectiveIn a cross‐sectional study we examined total cholesterol/high‐density lipoprotein cholesterol (TC/HDL) ratio and low‐density lipoprotein cholesterol (LDL/HDL) ratio in 66 Foreign‐born Afro Caribbean (FBAC) living in the US for less than 10 years, 62 US‐born Afro Caribbean American (USBACA) and 61 African American (AA) adults (18‐40 years).ResultsMales had significantly (p<0.01) higher mean TC/HDL and LDL/HDL ratios than females (4.0 ± 1.2 vs. 3.5 ± 1.4) and (2.62 ±1.1 vs. 2.20 ± 1.2), respectively. There were no significant statistical differences between the groups with respect to mean TC/HDL or LDL/HDL ratios. Using the TC/HDL ratio (蠅 5.0, high risk) predicted 15.3% of individuals at risk for coronary heart disease (CHD) (18.7% males and 12.2% females) whereas, using LDL/HDL ratio (蠅 3.6, high risk) predicted 14.3% of individuals at risk of CHD (16.5% males and 12.2% females). Also, more USBAC than FBAC and AA participants had elevated TC/HDL ratio 蠅 5.0 (19.4% vs. 13.6% and 13.1%) and, elevated LDL/HDL 蠅 3.6 (19.4% vs. 13.6% and 9.8%), respectively.ConclusionAlthough there were small differences between the predictive function of TC/HDL and LDL/HDL between the genders and the ethnic groups, this was not significant. However, because of ease of use (TC and HDL are measured values vs. LDL which is calculated) and TC being better reflective of the total lipid profile, we would suggest that the TC/HDL‐Cholesterol ratio be used for prediction of CHD risk.Source of funding: Florida International University Foundation