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Is Hdl Your Good Or Bad Cholesterol

How Is Good Cholesterol Measured

What is Cholesterol?

Good cholesterol or HDL cholesterol is generally measured in milligrams per decilitre or millimoles per litre via a blood test.

Good cholesterol or HDL cholesterol makes up one part of your total cholesterol levels. Generally speaking, cholesterol tests measure the amount of good cholesterol or cholesterol attached to HDL in the blood.

Cholesterol tests also offer a view on the percentage of HDL against the amount of total cholesterol. This can also be represented as a total cholesterol to HDL cholesterol ratio.

What Do Hdl And Ldl Mean

LDL and HDL are the two main types of cholesterol that make up your total cholesterol.

  • HDL , or good cholesterol, may protect the body against narrowing blood vessels
  • LDL , or bad cholesterol, may make arterial narrowing worse

There is a third type of cholesterol called VLDL , which is another type of bad cholesterol produced in the liver, and contains a high amount of triglycerides.

Data From Observational Studies

HDL-C is popularly known as good cholesterol and high levels are associated with low cardiovascular risk, but the role of HDL in vascular disease is complex. Anti-atherosclerotic effects of HDL-C include increment in reverse cholesterol transport and macrophage cholesterol efflux, anti-inflammatory activity, inhibition of low-density lipoprotein cholesterol oxidation, endothelial cell apoptosis. It also interferes with the thrombotic component of atherosclerosis by inhibiting platelet aggregation and reducing expression of cellular adhesion molecules.

The protective effect of HDL on atherosclerosis is suggested by the observation in humans that plasma HDL-C concentrations above 75 mg/dL are associated with prolonged life and relative freedom from coronary heart disease.

Studies in animals have shown that overexpression of the apolipoprotein A-I gene prevents the development or progression of atherosclerosis.

Serum HDL-C inversely predicts the time to a first major cardiovascular event as well as the risk of coronary events in patients with known CHD across a broad range of LDL-cholesterol levels. Low HDL-C is also a stronger predictor of CHD events in patients with an LDL-C < 125 mg/dl.

When divided into quintiles, the highest quintile of HDL-C had 40% lower rates of CHD than the lowest quintile .

In a meta-analysis of studies in the Asia-Pacific region, there was a negative correlation between HDL-C and CHD events , again underscoring the role of low HDL-C.

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How To Lower Ldl Cholesterol

Lifestyle and diet changes are the main ways to prevent or lower high LDL. A trial of eating a low-fat diet, regular aerobic activity, maintaining a healthy weight, and smaller waist circumference is an appropriate first step. It is best to set a timeline to achieve your goals with your doctor. In some cases, if those lifestyle changes are not enough, your physician may suggest a cholesterol lowering medication, such as a statin. If you are considering over-the-counter herbal or ayurvedic medications for cholesterol, please discuss those with your physician first as well.

Rarely, very high LDL is genetic and passed down in families. This is called familial hypercholesterolemia and is caused by a genetic mutation that decreases the livers ability to clear excess cholesterol. This condition can lead to very high LDL levels, and heart attack or stroke at a young age in multiple generations. Those individuals may require special medical treatment for prevention and treatment of atherosclerotic cardiovascular disease.

Remember, knowledge is the first step. If you dont know your cholesterol levels, get tested. That will give you and your physician a starting point for lifestyle changes and medications if needed. In the meantime, adopt a heart-healthy lifestyle, and do it with friends and family no matter their ages. Theres no time like the present to prevent heart disease.

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Last reviewed January 6, 2022

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Cholesterol a waxy substance that builds in the arteries is not completely harmful, despite its reputation for being bad for you. In fact, some of it can even improve your health when consumed in the right amounts.

The physicians at the USC Cardiac and Vascular Institute at Keck Medicine of USC can measure your good cholesterol and bad cholesterol levels, and help you adopt healthier eating and living habits so you can achieve the best balance of both.

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How Can I Raise My Hdl Level

If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:

  • Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
  • Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
  • Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
  • Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
  • Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.

How Do You Measure Hdl

HDL is typically measured by a blood test, also called a lipid profile or lipid panel, ordered by your doctor. To get an accurate reading, you’re typically asked to fast for at least 8 to 10 hours prior to the test.

You can also measure HDL levels at home with a digital cholesterol meter. To use one, you typically prick a finger with a lancet or fingerstick, add a drop of blood to a test strip, and insert the strip into the meter. While convenient, the reliability of readings from at-home cholesterol meters is debated.

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When Should You Contact Your Healthcare Provider About Your Cholesterol Levels

In truth, your healthcare provider will probably talk to you about your numbers first. As always, contact your provider if you have any new or worsening pain or other uncomfortable feelings. Make sure you know what medications you take and what they are expected to do. Call the provider if you have a reaction to the medicine.

Before you go to the office, and after you have had a cholesterol test, it helps to have a list of questions prepared about your test results and any proposed treatment.

A note from Cleveland Clinic

When considering cholesterol numbers, its important to remember that you really have the ability to make those numbers go in your favor. What you choose to eat, how much you are able to move and how you deal with lifes ups and downs are things that you can influence.

Last reviewed by a Cleveland Clinic medical professional on 07/31/2020.


What Are The Types Of Cholesterol

Cholesterol Good and Bad

Cholesterol moves throughout the body carried by lipoproteins in the blood. These lipoproteins include:

  • Low-density lipoprotein is one of the two main lipoproteins. LDL is often called the bad cholesterol.
  • High-density lipoprotein is the other main lipoprotein. HDL is often called the good cholesterol.
  • Very-low-density lipoproteins are particles in the blood that carry triglycerides.

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How To Prevent The Bad Cholesterol

Cholesterol is either from your liver, or it comes from animal-based foods. The best way to lower your LDL cholesterol is to limit the amount of animal fats consumed, including red meats and dairy products made with whole milk. The American Heart Association recommends limiting saturated fats, or those found in animal-based foods, to less than six percent of daily calories and minimizing the amount of trans fats, often found in processed foods. A heart-healthy diet with a variety of fruits, vegetables, poultry, fish, and whole grains can help lower or prevent bad cholesterol. Maintaining a healthy weight is also important as obesity tends to increase LDL.

What Are Normal Hdl And Ldl Levels

Now that you know about these two types of cholesterol, heres something else to keep in mind: When you hear about high and low cholesterol , those terms almost always refer to LDL, or the bad cholesterol.

To keep your body at its best, you want to have high levels of HDL and low levels of LDL. Think about it: You dont want too much of the bad cholesterol, and you want high enough levels of the good cholesterol that it can do its job fighting off the bad stuff.

So, where should your cholesterol levels be? Dr. Cho weighs in.

HDL levels

Ideally, you want your good cholesterol levels to be at 60 mg/dL or higher, though a standard range is 40 mg/dL to 59 mg/dL. When your HDL levels fall below 40, youre at an increased risk for heart disease.

In rare cases, you may have very high levels of HDL that isnt doing what it should be. Some people have dysfunctional HDL, Dr. Cho explains. In this case, you have very high levels of good cholesterol, but it essentially goes around your body and does nothing.

LDL levels

Its important to keep this number low to reduce the risk of various health concerns associated with high cholesterol. And the sooner you start keeping an eye on this number, the better one study shows that having high cholesterol from an early age increases your risks.

Ideal LDL levels vary based on your age, sex and health conditions, but for the most part, heres what to aim for:

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Medications To Reduce Ldl

Many medications can help decrease high cholesterol or LDL levels, such as:


Statins are the most common medication doctors use to treat high cholesterol. This drug may raise the risk of diabetes and cause changes in liver enzymes, although permanent liver damage is rare.


Doctors can prescribe lomitapide to treat familial hypercholesterolemia, a genetic condition that can cause high cholesterol. This drug may cause liver damage, so people taking it may require frequent liver testing.

Bile acid sequestrant medication

Doctors may prescribe bile acid sequestrants to reduce cholesterol levels when statins are not a suitable treatment or are not effective enough.

Bile acid sequestrants can raise triglyceride levels, reduce the efficacy of some medications, and cause diarrhea.

PCSK9 inhibitors

. Some recommend taking this alongside a statin if a person is at high risk of health complications or if they have a genetic condition that causes high cholesterol.

PCSK9 inhibitors can cause pain, swelling, and cold sensation at the injection site.


Doctors may prescribe ezetimibe when a person has a genetic condition causing high cholesterol. Similarly, doctors can prescribe it when statins cause too many side effects or are not effective enough on their own.


It may be necessary to refrain from eating or drinking anything except plain water 912 hours before the test.

Wednesday 27 September 2017

Good And Bad Cholesterol Stock Illustration

Given the seriousness with which its talked about, you could be forgiven for thinking that all cholesterol is terrible and out to kill you.

The truth is, a healthy level of cholesterol is actually essential for your body to run properly every cell in your body contains some cholesterol. Your body uses cholesterol to build cell walls, make vitamin D and produce hormones. In fact, about 75% of the cholesterol in your body is made by your liver. The rest comes from some of the foods and drinks you consume.

Cholesterol can become a serious health problem when your body has too much of it, especially one type in particular called low-density lipoprotein or LDL cholesterol. Read on to find out what cholesterol is, the difference between good and bad cholesterol and how you can try to keep your cholesterol at a healthy level.

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Can Bad Cholesterol Levels Be Too Low Can Good Cholesterol Levels Be Too High

It isnt often that people have bad cholesterol that is too low or good cholesterol that is too high. There are studies being done that suggest that extremes of any kind are not healthy for everyone.

Even though there is no clear-cut number about what LDL level is too low, levels under 40 mg/dL may be associated with certain health issues, including depression/anxiety, and hemorrhagic stroke.

However, there is data from clinical trials to support that there is no evidence of harm when LDLs remain < 40mg/dl on statin therapy.

In some cases, genetic conditions can cause you to have very low cholesterol levels. In other cases, nutritional problems, some cancers, hypothyroidism and certain infections can also cause low cholesterol levels. In any of these types of situations, the underlying issues need to be addressed.

In terms of having too much of a good thing, researchers are studying the effects of too much HDL, the good cholesterol. No conclusions have been reached, but there have been studies into the possible relationship between high HDL and cancer, and a greater risk of heart attack among the high risk. Excessively high HDL may be dysfunctional HDL and not protective.

What Can Affect My Ldl Level

Things that can affect your LDL level include:

  • Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise
  • Weight. Being overweight tends to raise your LDL level, lower your HDL level, and increase your total cholesterol level
  • Physical Activity. A lack of physical activity can lead to weight gain, which can raise your LDL level
  • Smoking.Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove LDL from your arteries, if you have less HDL, that can contribute to you having a higher LDL level.
  • Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.
  • Genetics. Your genes partly determine how much cholesterol your body makes. High cholesterol can run in families. For example, familial hypercholesterolemia is an inherited form of high blood cholesterol.
  • Medicines. Certain medicines, including steroids, some blood pressure medicines, and HIV/AIDS medicines, can raise your LDL level.
  • Other medical conditions. Diseases such as chronic kidney disease, diabetes, and HIV/AIDS can cause a higher LDL level.
  • Race. Certain races may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

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Can High Cholesterol Be Prevented Or Avoided

Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.

Eat fewer foods with saturated fats . Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat . Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.

Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.

What Does Bad Cholesterol Do

Good and Bad Cholesterol

Low-density lipoproteins transport cholesterol to cells and blood vessels in the body

The function of bad cholesterol isnt to cause health problems, we need a certain amount of LDL in the blood to live. There are certain factors that may lead to unhealthy levels of bad cholesterol therefore having a negative impact on ones overall health.

In simpler terms, bad cholesterol is referred to as such because it facilitates attachment of cholesterol and other lipids to the arteries, leading to blockages which often presents as a heart attack or a stroke.

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Ask The Doctor: Can Hdl Cholesterol Be Too High

Q.I know I need to keep my LDL cholesterol low and my HDL cholesterol high, but can HDL ever be too high?

A. For high-density lipoprotein levels, it does appear that the higher, the betterat least to a point. But you should also think about how you achieve that level. HDL is known as the “good” cholesterol particle because it functions to clear cholesterol from the arteries and deliver it back to the liver. Higher HDL levels are associated with a lower risk of heart disease. HDL levels lower than 40 milligrams per deciliter are considered worrisome, and levels higher than 60 mg/dL are considered excellent.

One recent study that examined high levels of HDL reported the benefits extended until 90 mg/dL in men, but then leveled off, which suggests no further benefit even with higher levels. A man’s HDL level is predominantly determined by genetics, or inherited factors. Moderate-intensity exercise, three to four times a week, is an important mechanism to raise HDL with the bonus of other health benefits. Other methods to raise HDL are not so healthy. For instance, medications or supplements, like niacin, have shown disappointing results in controlled studies. Alcohol intake is known to increase HDL, but consuming more than two standard drinks a day can raise your risk of high blood pressure, heart attack, and stroke.

–William Kormos, MD


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