Which combination yields the lowest risk of cardiovascular disease?

A) Moderate total levels of cholesterol with a ratio of total cholesterol to HDL of more than 6 to 1
B) Moderate total levels of cholesterol with a 3.5 to 1 ratio of total cholesterol to LDL
C) Low levels of total cholesterol with a ratio of total cholesterol to HDL of less than 4.5 to 1
D) Low total levels of cholesterol with a 3.5 to 1 ratio of LDL to total cholesterol

Low levels of total cholesterol with a ratio of total cholesterol to HDL of less than 4.5 to 1 is the combination that yields the lowest risk of cardiovascular disease. Both low total cholesterol levels and a favorable ratio of total cholesterol to HDL are important factors in reducing the risk of cardiovascular disease. The ratio of less than 4.5 to 1 is considered favorable because it indicates a higher level of HDL (the "good" cholesterol) in relation to total cholesterol. A ratio of more than 6 to 1, as in option A, indicates a higher risk of cardiovascular disease, while a ratio of 3.5 to 1 of LDL to total cholesterol, as in option B and D, does not take into account the levels of HDL and its protective effect.