HDL: The "Good" Cholesterol

Understanding HDL cholesterol is essential for heart health, as this "good" cholesterol helps remove harmful buildup from your arteries.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What are HDL and LDL?

HDL and LDL are two types of lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:

• HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.

How do I know what my HDL level is?

A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history.

For people who are age 19 or younger:

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older:

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

What should my HDL level be?

With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:

• Age 19 or younger: More than 45mg/dl
• Men age 20 or older: More than 40mg/dl
• Women age 20 or older: More than 50mg/dl

How can I raise my HDL level?

If your HDL level is too low, lifestyle changes may help:

• Eat a healthy diet: Eat good fats instead of bad fats. Limit saturated fats (full-fat milk, cheese, high-fat meats, butter, lard) and avoid trans fats (some margarines, fried foods, processed baked goods). Eat unsaturated fats (avocado, olive oil, nuts). Limit carbohydrates, especially sugar, and eat more fiber-rich foods like 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: 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.
• Limit alcohol: Too much alcohol can make you gain weight, which lowers your HDL level.

Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL, but if you have a low HDL and high LDL level, you might need medicine.

What else can affect my HDL level?

Taking certain medicines can lower HDL levels in some people, including:

• Beta blockers (blood pressure medicine)
• Anabolic steroids (including testosterone)
• Progestins (female hormones in some birth control pills and hormone replacement therapy)
• Benzodiazepines (sedatives used for anxiety and insomnia)

Diabetes can also lower your HDL level, so that gives you another reason to manage your diabetes.