Summary

HDL cholesterol is an abbreviation for high-density lipoprotein, and it circulates in your bloodstream. It is also called the "good" cholesterol as it helps to remove excess cholesterol from the blood to the liver, where it is broken down and eliminated from your body.

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Overview

HDL cholesterol is secreted by the liver and small intestines. It is also found in foods that are high in unsaturated fat, such as nuts, seeds, olive oil, avocado, and fatty fish.

It is another biomarker that helps to indicate your cardiovascular health and the risk of developing atherosclerosis (buildup of plaque in your arteries). Higher HDL levels are associated with a decreased risk of cardiovascular diseases. Furthermore, HDL can extract cholesterol from plaques leading to plaque regression and stabilization. Atherosclerosis can lead to coronary artery disease, angina, heart attack, peripheral artery disease, carotid artery disease, and stroke.^[1,2]

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What should you know about this biomarker?

Each laboratory uses different machines and protocols so the results might vary in terms of the reference ranges or used units of measurement. 

In Macromo blood tests we use mmol/l (millimole per liter), but you may also find values in mg/dl (milligram per deciliter) on the internet.

Values of 1.00 mmol/l(millimoles per liter of blood) or higher for men and 1.20 mmol/l or higher for women are considered optimal for those at low risk for heart disease. Those at higher risk may benefit from even higher levels.^[1]

There are three possible states of your blood test result: low, average, and high levels.

• If your HDL cholesterol level is below the reference range, try increasing physical activity, quitting smoking (if applicable), and maintaining a diet high in healthy fats. Please consult your healthcare provider to discuss potential strategies for increasing HDL levels.
• If your HDL cholesterol is within the reference range, that is the best-case scenario. Healthy lifestyle habits are the key to keeping your 'good' cholesterol levels stable.
• If your HDL cholesterol level is higher than the reference range, it is usually a good sign. However, extremely high levels may need medical investigation. 

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Genetics

The heritability of HDL cholesterol (HDL-C) is estimated to be 62–77%. Some people may have low HDL cholesterol due to genetic factors, such as Tangier disease (mutation in ABCA1 gene) or familial hypoalphalipoproteinemia.^[3,4]

One study found that people who were homozygous and compound heterozygous for the APOA1 gene had almost no plasma HDL cholesterol. 

Mutations that lead to higher levels of HDL cholesterol have also been observed. These genetic changes are associated with the CEPT gene, but the results suggest both pro- and anti-atherogenic effects and more research is needed.^[3] 

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Recommendations

If your HDL cholesterol result is lower than the optimal range, it is a good decision to consider taking some steps:

• Eat a heart-healthy diet that is low in saturated fat, trans fat, and cholesterol, and high in fruits, vegetables, whole grains, and lean protein. 
• Increase your physical activity to at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. Aerobic exercise, such as walking, jogging, cycling, or swimming, can raise your HDL cholesterol and lower your LDL cholesterol and triglycerides.
• Quit smoking if you are a smoker, as smoking can lower your HDL cholesterol and damage your blood vessels.
• Lose weight if you are overweight or obese, as excess weight can lower your HDL cholesterol and raise your LDL cholesterol and triglycerides.
• Take medication if prescribed by your doctor, such as niacin, fibrates, or CETP inhibitors. It can increase your HDL cholesterol.

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The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.