HDL is a lipoprotein that transports cholesterol from tissues to the liver (reverse cholesterol transport) and is associated with lower risk of atherosclerotic cardiovascular disease. While higher HDL correlates with protection, current care prioritizes lowering LDL. Lifestyle measures - exercise, smoking cessation, healthy weight, and a diet low in saturated and trans fats - support better cholesterol balance. Clinical decisions should consider HDL alongside LDL, triglycerides, and overall risk.
What is HDL?
HDL (high-density lipoprotein) is a blood lipoprotein often called the "good" cholesterol. HDL particles pick up cholesterol from artery walls and other tissues and carry it to the liver for processing and removal. This process, called reverse cholesterol transport, helps limit plaque buildup in arteries.
How HDL differs from LDL
LDL (low-density lipoprotein) carries cholesterol from the liver to tissues. When LDL particles deposit cholesterol in arterial walls, they contribute to atherosclerosis, which raises the risk of heart attack and stroke. In contrast, higher HDL levels are associated with lower cardiovascular risk because HDL supports cholesterol clearance.
Current clinical guidelines focus primarily on lowering LDL cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) risk. Although higher HDL is linked with lower risk, clinical trials have not consistently shown that drugs that raise HDL automatically reduce heart attacks or strokes.
How your body makes HDL
The liver and intestines produce HDL particles. Proteins such as apolipoprotein A-I help form nascent HDL, which accepts cholesterol from cells. The liver then remodels and clears HDL along with the cholesterol it carries.
Lifestyle factors that affect HDL
- Physical activity tends to raise HDL.
- Smoking lowers HDL.
- Excess body weight often lowers HDL.
- Diets high in saturated and trans fats raise LDL more than they raise HDL; replacing those fats with unsaturated fats can improve your cholesterol profile.
- Moderate alcohol intake can increase HDL for some people, but alcohol is not recommended as a strategy to improve heart health because of other risks.
What are target HDL levels?
Laboratory reference ranges vary, but common clinical cutoffs used in the U.S. are:
- Low: less than 40 mg/dL for men and less than 50 mg/dL for women
- Acceptable: 40-59 mg/dL
- Considered protective: 60 mg/dL or higher
When to act and what to do
Focus first on lowering LDL if it is elevated. Lifestyle steps that help HDL and overall heart health include regular aerobic exercise, smoking cessation, weight loss when appropriate, and a diet rich in vegetables, fruits, whole grains, and unsaturated fats. Medications such as statins target LDL and remain the main pharmacologic strategy for reducing ASCVD risk.
Talk with your clinician to interpret your lipid panel and to develop a personalized plan that considers both HDL and other risk factors.
FAQs about Hdl Cholesterol
Why is HDL called the "good" cholesterol?
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News about Hdl Cholesterol
Want Higher HDL Fast? Do These 7 Habits Safely, According to Experts. - Men's Health [Visit Site | Read More]
Low HDL Cholesterol Linked to Higher Risk of HFpEF in Middle Age - Consultant360 [Visit Site | Read More]
The complex story of HDL cholesterol - Harvard Health [Visit Site | Read More]
Cholesterol uptake capacity of HDL in culture medium of fresh primary human hepatocytes: an in vitro system for screening anti-atherosclerosis drugs focused on HDL functions - BMC Research Notes [Visit Site | Read More]
High HDL Cholesterol Linked to Elevated Fracture Risk in Men - Medscape [Visit Site | Read More]