HDL cholesterol
Also known as: HDL, HDL-C, high-density lipoprotein cholesterol, good cholesterol
The cholesterol carried by high-density lipoprotein, the particle that collects cholesterol from tissues and artery walls and returns it to the liver. A higher level is associated with lower cardiovascular risk and enters the standard risk calculators.
- Also known as
- HDL, HDL-C, high-density lipoprotein cholesterol, good cholesterol
- Units
- mmol/L (UK) or mg/dL (US)
- Measured by
- Lipid profile
What it is and what it does
HDL particles are made by the liver and gut and pick up cholesterol from peripheral cells, including the foam cells of a developing plaque, delivering it back to the liver for excretion in bile (reverse cholesterol transport). Population studies show a steady fall in heart disease as HDL rises, so it appears in risk scores such as QRISK as the total-to-HDL ratio. Drugs that raise HDL have not, however, reduced heart attacks in trials, so HDL is read as a risk marker rather than a treatment target. Exercise, weight loss, stopping smoking and moderate alcohol raise it; obesity, inactivity, smoking, type 2 diabetes and high triglycerides lower it.
Why it may be higher
- Regular aerobic exercise, moderate alcohol intake, oestrogen
- Some inherited traits (usually harmless); very high values with some genetic variants are of uncertain significance
Why it may be lower
- Obesity, physical inactivity, smoking
- Type 2 diabetes, high triglycerides, metabolic syndrome
- Anabolic steroids, some beta blockers and progestogens
- Rare inherited HDL deficiencies
A high or low value can be associated with several different situations. The result is interpreted with other results, symptoms, history and clinical findings.
What can affect the result
- Recent alcohol, weight change and exercise habits
- Acute illness
- Menopause and hormone treatment