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Research HDL-C
Lipid Panel Atherosclerosis

HDL-C

Other names: HDL CHOLESTEROL, HDL Cholesterol Direct

Optimal Result: 39 - 80 mg/dL, or 1.01 - 2.07 mmol/L.

High-density lipoprotein cholesterol (HDL-C) is a type of cholesterol and is typically assessed in a blood test called a lipid profile, which is used to monitor lipid levels and determine an individual’s risk of developing heart disease. Frequently referred to as “good” cholesterol, HDL-C removes excess cholesterol from tissues and carries it to the liver for disposal. It is recommended that a lipid profile be done every four to six years in all adults with no risk factors for heart disease.

A test for high-density lipoprotein cholesterol may be ordered more frequently for those who have one or more risk factors for heart disease, including:

- Cigarette smoking

- Being overweight or obese

- Unhealthy diet

- Being physically inactive

- Age (men 45 years or older & women 55 years or older)

- Hypertension (high blood pressure)

- Family history of heart disease

- Diabetes

High-density lipoprotein cholesterol levels may also be monitored to evaluate the success of lifestyle changes such as diet and exercise or cessation of cigarette smoking.  It is worth noting that in women, pregnancy may cause changes in HDL.

Normal Ranges:

HDL level in mg/dL

Risk of heart disease (independent of other risk factors)

Less than 40 (men) or less than (50) women

Above average

40-50 (men) or 50-59 (women)

Average

60 or higher

Less than average

What does it mean if your HDL-C result is too high?

HDL cholesterol, often referred to as "good" cholesterol, has long been associated with cardiovascular health benefits. Traditionally, higher levels of HDL-C were thought to indicate a lower risk of heart disease, as HDL-C plays a crucial role in removing excess cholesterol from the bloodstream and transporting it to the liver for disposal. However, recent research has unveiled a more nuanced relationship between HDL-C levels and cardiovascular risk. Two prospective cohort studies have revealed a surprising paradox: extremely high HDL-C levels (above 80 mg/dL for men and above 100 mg/dL for women) are associated with increased mortality risk in both sexes. [L, L]. This finding challenges the conventional wisdom of "the higher, the better" regarding HDL-C levels. Instead, it suggests a U-shaped relationship between HDL-C and cardiovascular health, where both very low and very high levels may be detrimental. Several hypotheses have been proposed to explain this paradoxical association:

  1. Genetic factors: Mutations in genes involved in HDL metabolism, such as SCARB1 or CETP, might lead to very high HDL-C levels while simultaneously increasing cardiovascular risk.
  2. HDL functionality: Extremely high HDL-C levels may indicate the presence of dysfunctional HDL particles that are less effective at performing their protective roles, such as reverse cholesterol transport and anti-inflammatory actions.
  3. Lifestyle factors: High alcohol consumption, which can raise HDL-C levels, might contribute to the increased mortality risk observed in individuals with very high HDL-C.
  4. Underlying health conditions: Certain diseases or metabolic disorders that affect lipid metabolism could result in both elevated HDL-C and increased health risks.

These findings highlight the importance of considering HDL-C levels within a broader context of overall health and other cardiovascular risk factors. They also underscore the need for further research into the qualitative aspects of HDL particles, not just their quantity. Healthcare providers may need to reassess their approach to lipid management, particularly for patients with very high HDL-C levels. Instead of focusing solely on raising HDL-C, a more comprehensive strategy that considers the entire lipid profile, including LDL-C and triglycerides, as well as other cardiovascular risk factors, may be more effective in reducing overall cardiovascular risk. Moreover, these studies emphasize the importance of personalized medicine in cardiovascular health. What's optimal for one individual may not be ideal for another, and factors such as genetics, lifestyle, and overall health status should be taken into account when interpreting lipid profiles and making treatment decisions.

In conclusion, while HDL-C remains an important factor in cardiovascular health, its relationship with disease risk is more complex than previously thought. This evolving understanding of lipid metabolism and cardiovascular risk underscores the need for ongoing research and a more nuanced approach to preventive cardiology.

What does it mean if your HDL-C result is too low?

High-Density Lipoprotein (HDL) is known as good Cholesterol. HDL-C cholesterol protects agains heart disease by taking the "bad" cholesterol out of your blood and preventing it from building up in your arteries. The higher your HDL cholesterol number, the lower your risk of heart disease.

HDL-C levels are typically lower in people who have a metabolic syndrome—a cluster of conditions that include obesity, increased blood pressure, and high blood sugar levels. Low levels of HDL-C are undesirable in that a higher level would offer protection against heart attack and stroke.

There are some interventions known to increase HDL-C, including:

- Exercise

- Cessation of smoking

- Improving the diet (avoiding trans fats)

There are some drugs that can artificially raise HDL-C levels, but this is not associated with decreased risk of heart attacks or strokes.

Frequently asked questions

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Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.

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Yes, you can! Go to the Graph view or Spreadsheet view. In the top-right corner, click "Export to Excel," and the file will be downloaded to your device.

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