Other names: HDL CHOLESTEROL, HDL Cholesterol Direct, HDL - Cholesterol
High-Density Lipoprotein Cholesterol (HDL-C), often called “good cholesterol,” is a key component measured in a Lipid Panel (Lipid Profile) blood test. HDL-C plays a protective role in heart health by removing excess cholesterol from the bloodstream and transporting it to the liver for elimination. Higher levels of HDL-C are generally associated with a lower risk of cardiovascular disease (CVD), including heart attacks and strokes.
An HDL-C test helps evaluate your risk of developing heart disease by assessing how effectively your body clears cholesterol. Unlike Low-Density Lipoprotein (LDL-C), which contributes to plaque buildup in arteries, HDL-C helps maintain clear and flexible blood vessels.
All adults should have their HDL-C checked as part of a lipid panel every 4 to 6 years.
Testing is recommended more frequently if you have risk factors for heart disease, including:
Smoking cigarettes
Overweight or obesity
Poor diet high in saturated fats or trans fats
Physical inactivity
High blood pressure (hypertension)
Diabetes or insulin resistance
Family history of premature heart disease
Age (Men ≥45 years, Women ≥55 years)
Your healthcare provider may order repeat HDL-C tests to:
Track the impact of lifestyle changes like a healthier diet, regular exercise, or quitting smoking.
Assess your response to cholesterol-lowering medications if prescribed.
Evaluate cholesterol fluctuations during pregnancy, as hormonal changes can affect HDL levels in women.
| HDL-C Level (mg/dL) | Men | Women | Cardiovascular Risk |
|---|---|---|---|
| Less than 40 | < 40 | < 50 | Higher than average risk |
| 40–50 | 40–50 | 50–59 | Average risk |
| 60 or higher | ≥ 60 | ≥ 60 | Lower than average risk |
Key Insight: Higher HDL-C levels are protective against heart disease, but very high levels (>100 mg/dL) may not always confer additional benefit and should be interpreted in clinical context.
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HDL cholesterol (HDL-C), often called “good cholesterol,” has long been associated with heart health. Traditionally, higher HDL-C levels were thought to lower the risk of heart disease because HDL helps remove excess cholesterol from the arteries and transports it to the liver for elimination — a process known as reverse cholesterol transport.
However, recent research challenges the idea that “the higher, the better” when it comes to HDL levels. Large prospective cohort studies have revealed a U-shaped relationship between HDL-C and cardiovascular risk. While low HDL-C is a known risk factor for heart disease, extremely high HDL-C levels — above 80 mg/dL in men and 100 mg/dL in women — have been linked to increased mortality and cardiovascular events.
Several theories explain why extremely high HDL-C might not be beneficial:
Genetic Mutations
Variations in genes such as SCARB1 or CETP can cause abnormally high HDL-C levels while disrupting HDL function, potentially increasing cardiovascular risk.
Dysfunctional HDL Particles
High HDL-C levels do not always mean functional HDL. In some cases, HDL particles may lose their protective abilities, becoming less effective at removing cholesterol or even promoting inflammation and oxidative stress.
High Alcohol Consumption
Excessive alcohol intake can artificially elevate HDL-C levels while simultaneously raising the risk of liver disease, arrhythmias, and stroke.
Underlying Health Conditions
Certain metabolic disorders or chronic inflammatory diseases can alter lipid metabolism, resulting in elevated HDL-C levels that are not protective and may reflect underlying health issues.
These findings suggest that HDL-C should not be interpreted in isolation. Both very low and very high HDL-C levels could indicate an increased health risk, depending on the broader clinical context.
Focus on the overall lipid profile, including LDL-C ("bad cholesterol") and triglycerides.
Evaluate other cardiovascular risk factors: blood pressure, blood sugar, family history, smoking status, and lifestyle habits.
Recognize that quality matters as much as quantity when it comes to HDL. Functional HDL particles are crucial for cardiovascular protection.
Consider personalized medical approaches: Genetic background, metabolic health, and lifestyle choices all influence how HDL-C affects your heart disease risk.
Rather than aiming to simply "raise HDL-C," current research emphasizes a more comprehensive strategy to reduce cardiovascular risk. This includes:
Healthy lifestyle modifications (diet, exercise, smoking cessation)
Managing LDL-C and triglycerides
Addressing underlying conditions like insulin resistance or chronic inflammation
Considering emerging tests that assess HDL particle function and size for a more precise evaluation
While HDL-C remains a key marker of cardiovascular health, its role is more complex than once believed. Both low and excessively high HDL levels may signal underlying problems. Understanding the quality and functionality of HDL, alongside other risk factors, is essential for accurate cardiovascular risk assessment and effective prevention strategies.
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As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
High-Density Lipoprotein Cholesterol (HDL-C) is commonly known as “good cholesterol” because it helps clear excess cholesterol from your blood vessels and carries it to the liver for removal. When HDL-C levels are too low, your body’s ability to remove cholesterol diminishes, increasing your risk of atherosclerosis, heart disease, and stroke.
Men: Less than 40 mg/dL
Women: Less than 50 mg/dL
A low HDL-C level is considered a cardiovascular risk factor, especially when combined with high LDL-C ("bad cholesterol"), elevated triglycerides, high blood pressure, or diabetes.
Several factors can contribute to low HDL cholesterol, including:
Smoking
Obesity and excess body fat, particularly around the waist
Lack of physical activity
Unhealthy, high-carbohydrate diet
Chronic conditions like type 2 diabetes or metabolic syndrome
Genetics (inherited low HDL levels)
Low HDL-C levels are linked to:
Increased plaque buildup in arteries (atherosclerosis)
Higher risk of coronary artery disease (CAD)
Elevated risk for heart attacks and strokes
Association with insulin resistance and metabolic syndrome
Raising HDL levels typically involves improving lifestyle habits:
Quit smoking – Smoking lowers HDL and damages artery walls.
Exercise regularly – Aerobic activities (brisk walking, jogging, cycling) can boost HDL.
Adopt a heart-healthy diet – Focus on healthy fats (olive oil, avocados, nuts) and cut back on refined carbs and sugars.
Achieve and maintain a healthy weight – Losing even 5-10% of body weight can improve HDL.
Limit alcohol consumption – Moderate alcohol intake may raise HDL, but excess is harmful.
Manage blood sugar and insulin resistance – Especially important for those with diabetes or prediabetes.
If your HDL-C is low, talk to your healthcare provider about your overall lipid profile and heart disease risk. While medications specifically to raise HDL are uncommon, your doctor may address other cholesterol abnormalities or recommend therapies to reduce cardiovascular risk.
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Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
Healthmatters is a highly-personalized health dashboard.
Instead of searching for your lab results in different places or tracking them down from different providers, Healthmatters houses, organizes, and interprets them all in one central location.
With a Healthmatters account, you can dive into the details of each biomarker and gain insights into the meaning behind your medical test data, anytime, anywhere.
For our professional users, Healthmatters provides intuitive tools that not only streamline analysis but also save valuable time when delving into your client's lab report history.
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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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%sdLDL-C, Apo B : Apo A-1, ApoA-I, Apolipoprotein E (APOE), Atherogenic index, Estimated CHD Risk, Fibrinogen, Glycomark (1 ,5-Anhydroglucitol), HDL % of Total Cholesterol, HDL-C, HDL-C/TG, hsCRP, IDL Cholesterol, LDL-C, LDL/HDL Cholesterol Ratio, Leptin : Adiponectin ratio, Myeloperoxidase (MPO), Non-HDL Cholesterol, Oxidized LDL, Oxidized LDL : LDL-C, OxLDL (Oxidized LDL), PLAC, PLAC (LP-PLA2 Activity), Small dense LDL Cholesterol, Small dense LDL-C : LDL-C, Total Cholesterol, Total Cholesterol/HDL Ratio, Triglycerides, Triglycerides to HDL Ratio, VLDL-C/TG, VLDL-C/TG (Boston Heart)
