Why Are Hdls Called Good Cholesterol

Why Hdl Cholesterol Is Good

For many years HDL cholesterol has been called good because it carries plaque-forming particles from your arteries and bloodstream back to your liver where they can be removed from your body. A study from Texas Medical Center showed that regular HDL cholesterol may not be very effective in doing this, but another form called Nascent HDL carries these protein-fats much more quickly to your liver to be removed from your circulation . The Nascent HDL cholesterol goes directly to your liver and skips being converted to the mature form of HDL. It can clear plaque-forming particles from your arteries, and carry them to your liver, a thousand times faster than regular HDL does. It takes Nascent HDL less than two minutes to do this job, compared to several days that HDL is thought to take. For a long time, doctors have questioned the value of using HDL levels to predict heart attacks. A review of 15 studies shows that the risk for heart attacks does not vary directly with the concentration of HDL in your bloodstream .

Cholesterol Levels In Children

Seven percent of American children between the ages of 6 and 19 have high cholesterol, according to the CDC. That’s compared with 12 percent of American adults who have high levels.

Though children are less likely than adults to have unhealthy cholesterol levels, they should be tested nonetheless. Any child or adult with a family history of high cholesterol, heart disease, or diabetes should be particularly vigilant about having their cholesterol checked.

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.

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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.

Good Cholesterol To Bad Cholesterol:

For a healthy adult, the cholesterol in the body should range from 100-200mg/dl, LDL should be below 60mg/dl and HDL should be more than 60mg/dl. If a person consumes animal products like meat, fish, pork, mutton, beef etc or dairy products in excess his body will generate more LDL than HDL which will lead to cholesterol imbalance. Another reason for high LDL is genetics. In some cases, the liver produces double the amount of cholesterol required by the body. A person can suffer from high cholesterol if they are a regular smoker, overweight/obese, inactive, consume unhealthy diet, have a thyroid disorder, kidney disease or suffer from diabetes.

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How Is An Hdl Cholesterol Test Different From A Total Cholesterol Test

A total cholesterol test measures the sum of all cholesterol found in different kinds of lipoproteins. The total cholesterol number includes HDL cholesterol, LDL cholesterol, and VLDL cholesterol.

Because these kinds of cholesterol have distinct implications for cardiovascular health, tests of total cholesterol often measure HDL cholesterol as well so that more information is provided about the ratio of HDL to non-HDL cholesterol in the blood.

Hdl: The Good But Complex Cholesterol

More HDL cholesterol is better, but the benefits may depend on how you get there.

In the simplest telling of the cholesterol story, HDL fights LDL . Like knights in shining armor, HDL particles patrol the blood vessels, snatching cholesterol from circulating LDL particles and from the dangerous, gooey plaque that lines artery walls. The knights of the HDL cholesterol carry their fatty cargo to the liver for recycling or disposal.

The real story isn’t quite so simple. HDL cholesterol is turning out to be a much more complex substance than we once believed. Instead of a single kind of particle, HDL cholesterol is a family of different particles. Although they all contain lipids , cholesterol, and proteins called apolipoproteins, some types are spherical while others are doughnut-shaped. Some types of HDL are great at plucking cholesterol from LDL and artery walls while other types are indifferent to cholesterol, and some even transfer cholesterol the wrong way into LDL and cells.

To further complicate matters, different HDL types do more than just carry cholesterol. Some protect LDL from being chemically altered by oxygen, a change that makes LDL extra harmful to artery walls. Under some circumstances, though, they can do just the opposite. Various HDL particles can ease inflammation in artery walls, stimulate production of nitric oxide, a molecule that helps artery walls relax, and help prevent blood clots from forming inside arteries.

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Targets For Cholesterol Levels

Here are recommended levels of lipids in your blood measured in milligrams per deciliter .

• Total cholesterol: Under 200 mg/dL
• Total triglycerides: Under 150 mg/dL
• LDL cholesterol: Under 130 mg/dL for healthy individuals, or under 100 mg/dL for heart or blood vessel disease, or for those with high total cholesterol
• HDL cholesterol: More than 45 mg/dL for men, or more than 55 mg/dL for women

Statistics about cholesterol include:

• In the United States, cardiovascular disease is the leading cause of death in adults. High cholesterol is a primary risk factor in cardiovascular disease.
• Of adults age 20 and older, 11.8% have a total cholesterol of 240 mg/dL or more.
• The average total cholesterol level for adults over age 20 in the United States is 191 mg/dL.
• Of adults in the U.S., 18% have low HDL cholesterol levels.
• Low HDL cholesterol is more prevalent in the United States among people of Hispanic descent than those from other ethnic groups.

Determination Of Hdl Cholesterol In The Clinical Laboratory

The standard method for the determination of cholesterol in LDL and HDL is the combined method of precipitation and ultracentrifugation . In the first step, VLDL is recovered by means of ultracentrifugation, then LDL is precipitated and finally HDL-C is determined enzymatically in the supernatant. This method is not suitable for use in the clinical laboratory because of high costs and complexity. In the late 1990s, homogeneous methods were introduced which allow the measurement of HDL-C in a single reaction vessel with no prior separation steps . In these methods, the cholesterol in non-HDL particles is masked with antibodies, polymers or detergents, and in a second reaction step HDL-C is determined enzymatically. The commercially available homogeneous assays show a good agreement with the reference method in normolipidemic samples and in many cases of hypercholesterolemia. The determination of HDL-C is hardly affected by prior consumption of food and the results can usually well be interpreted in post-prandial samples . Differences to the reference method and between the assays are, however, observed in hypertriglyceridemia , at low HDL-C , and if atypical lipoproteins are present . In these cases, HDL-C can be accurately measured by lipoprotein electrophoresis, however by staining lipoproteins using enzymatic cholesterol oxidation rather than unspecific lipophilic chemicals.

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Major Lipids In The Human Body

Lipids are a heterogeneous group of compounds which are relatively insoluble in water and soluble in non-polar solvents. Triglycerides , cholesterol, and phospholipids are the major lipids in the body. They are transported as complexes of lipid and proteins known as lipoproteins.

TGs : TGs are formed by combining glycerol with three molecules of fatty acid. TGs, as major components of VLDL and chylomicrons, play an important role in metabolism. When the body requires fatty acids as an energy source, the hormone glucagon signals the breakdown of the TGs by lipase to release free fatty acids. TGs are water-insoluble, non-polar neutral fats. These are not the structural components of biological membranes. TGs synthesis and storage mostly occurs in liver and adipose tissue. Free fatty acids and glycerol must be activated prior to the synthesis of TGs into acyl-coA and glycerol-3-phosphate respectively.

Phospholipids: Phospholipids are TGs that are covalently bonded to a phosphate group by an ester linkage. Phospholipids perform important functions including regulating membrane permeability and in maintaining electron transport chain in mitochondria. They participate in the reverse cholesterol transport and thus help in the removal of cholesterol from the body. They are involved in signal transmission across membranes and they act as detergents and help in solubilization of cholesterol.

• Chylomicrons

Ldl As A Risk Factor For Heart Disease

LDL carries about 60-70% of serum cholesterol . It transports cholesterol from the liver to the peripheral tissues. High levels of LDL-C are harmful because it can build up on the arterial walls to initiate the formation of atherosclerotic plaques. Unlike the other lipoproteins, each LDL particle contains mostly one apoB-100 which is responsible for the selective binding of LDL to the LDLR. The binding of LDL to its receptor in the liver is the major mechanism used to remove LDL from circulation. Using this mechanism, about 70% of LDL are removed by the liver, releasing FC . The increase in intracellular cholesterol can affect blood cholesterol levels by inhibiting de novo synthesis of cholesterol, decreasing the synthesis of the LDLR, and increasing the activity of an enzyme that facilitates cholesterol storage .

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Good Cholesterol Is A Complex Measure

While the cholesterol-carrying function of HDL is important, it’s not the only way HDL helps your body function. HDL also alters the chemical composition of LDL, preventing it from becoming oxidized, Harvard Medical School reported in 2019. That prevents damage to the arteries and lowers inflammation.

In general, having more HDL is often associated with a lower risk of heart disease. But too much HDL can also cause an inflammatory response in your immune cells, according to a 2016 study in the journal Cell Metabolism. That response can counter its usual anti-inflammatory properties. The upshot is that HDL’s function isn’t so clear-cut as being “good,” rather, its benefit to the body depends on a balance between its positive and negative effects.

To further complicate matters, a separate report from Harvard Medical School suggests that HDL might, in the end, be more of a “bystander” than an agent of good. It might simply be a “marker” of your cholesterol level, rather than having a significant influence on the body.

In fact, the American Heart Association no longer recommends a specific range for HDL and LDL cholesterol instead, they look at cholesterol as part of your entire heart health.

The takeaway, if you’re managing cholesterol, is not to put too much stake into one number. Healthy diet, exercise, and other lifestyle changes can boost your heart health regardless of the precise amount of “good” cholesterol in your body.

Questions For Your Doctor About Test Results

Talking with your doctor can provide the most detailed information about your HDL cholesterol test results. Some of the following questions may be useful in obtaining detailed explanations from your physician:

• What was my HDL cholesterol level? Is that level healthy for me?
• Were any other types of cholesterol measured? If so, what were the results of those measurements?
• Do I have risk factors for cardiovascular disease?
• Should I have another cholesterol test? If so, when?
• Are there any other tests that you recommend to evaluate my cardiovascular health?
• Do you recommend any lifestyle changes or treatments to reduce my risk of cardiovascular disease?

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What Causes Low Hdl Cholesterol

There are many reasons why some people have low HDL and others have high HDL. Genes appear to play the most important role by determining how much HDL cholesterol your body makes and the proportion of different subtypes.

Lifestyle choices also affect HDL levels. Smoking, carrying too many pounds, and lack of physical activity tend to lower HDL. So does a diet high in refined carbohydrates . Medications such as beta blockers, anabolic steroids, progestins, and benzodiazepines can also depress HDL.

How Is An Hdl Cholesterol Test Different From A Low

An HDL cholesterol test and LDL cholesterol test measure different types of cholesterol. The two types of cholesterol are transported in the blood in distinct kinds of particles.

In common descriptions, HDL cholesterol is known as good cholesterol while LDL cholesterol is bad cholesterol. The amount of HDL cholesterol compared to LDL cholesterol can be an important consideration in cardiovascular health.

Measuring HDL cholesterol is more straightforward than measuring LDL cholesterol. For this reason, levels of LDL cholesterol are most often calculated using a formula based on levels of total cholesterol, HDL cholesterol, and triglycerides. In some situations, though, a doctor may prescribe a direct LDL test.

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Cholesterol Levels In Women

As noted, women with healthy cholesterol levels have slightly higher HDL counts than men. That’s because estrogen increases HDL cholesterol and lowers LDL cholesterol, as noted in the Circulation study.

Because of estrogen’s protective effects, women tend to have a lower risk of heart disease before the age of 65. Once women have gone through menopause, their risk of heart attack and stroke is equal to men’s risk.

While men and women have similar targets numbers for total cholesterol, LDL, and triglycerides, women need to aim a little higher when it comes to HDL. The goal is 50 mg/dl or higher.

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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Keep Your Cholesterol Counts Under Control

Maintaining healthy levels of cholesterol is manageable. Medication is key, along with eating a healthy diet with lots of vegetables and getting regular exercise.

The experts at the USC CardioVascular Thoracic Institute can help you understand your count and give you the support you need to maintain cholesterol levels needed for a healthy heart. Request an appointment today or call .

Hdl Cholesterol: Too Much Of A Good Thing

As with many other good things in life, this usually helpful protein is best in moderation.

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I used to be thrilled that my blood level of HDL cholesterol, the so-called good cholesterol, was high, the likely result of my devotion to daily physical activity. After all, HDL, for high-density lipoprotein, acts like an arterial cleanser, removing cholesterol from blood vessels and preparing it for removal outside the body.

An ample supply of HDL cholesterol in blood serum has long been linked to protection against coronary heart disease and stroke, so what could be bad?

I now know that, as with many other good things in life, there can be too much of this usually helpful protein. The best available evidence has shown that most of us would probably be best off aiming for moderation with regard to serum levels of HDL.

A series of studies, large and small, in this country and abroad shows that the relationship of HDL levels to heart disease and overall mortality forms a U-shaped curve: too little and too much of this blood lipid are, on average, associated with an elevated risk of heart disease, cancer and premature death.

These findings, among others, are prompting doctors to rethink their approach to patients who may have an elevated risk of developing a heart attack, stroke or other life-threatening cardiovascular problem.

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