Many people think of cholesterol as something that should be as low as possible. After all, high cholesterol is a well-documented risk factor for heart disease.
The Centers for Disease Control and Prevention (CDC) notes that that high cholesterol increases a person’s risk of heart disease and stroke, adding that around
However, cholesterol levels are more complicated than that, as different types have different impacts. High-density lipoprotein (HDL) cholesterol, often known as “good” cholesterol, helps remove “bad” low-density lipoprotein (LDL) cholesterol from the body. For this reason, doctors consider it beneficial. However, there is still more to discover, and researchers are still learning how HDL and other types of cholesterol work.
In this article, we look at whether or not HDL cholesterol can be too high. We also look at what healthy levels are, and what can happen to people if HDL falls out of this range.
LDL cholesterol contributes to the fatty buildup that can clog a person’s arteries. When this buildup clogs or narrows the arteries, a heart attack or stroke is more likely to occur. With LDL cholesterol, lower is better.
HDL cholesterol helps remove LDL cholesterol from the blood and transports it to the liver for processing and elimination. A higher HDL number is desirable because it usually signals a lower risk of heart disease.
Some experts also believe HDL may have anti-inflammatory, anticoagulant, antioxidant, and other properties that may offer additional protection from cardiovascular disease.
Lifestyle recommendations for managing cholesterol focus on balancing the types of cholesterol by increasing HDL levels and lowering LDL.
The CDC recommends aiming for HDL levels of
Previous research suggests the higher the HDL levels, the more protection a person has from heart disease. However, new evidence is appearing that may challenge this. Some experts are now talking about a U-shaped relationship, in which both very low and very high HDL levels may be harmful.
Some scientists now believe that genetic, lifestyle, and environmental factors may affect the way HDL accumulates in the body and how it behaves, and that some of these effects could be harmful to some people. However, it is still unclear whether this happens and, if so, who it affects and why.
In 2010, some
Some experts believe that, in certain conditions, HDL particles may take on inflammatory properties rather than protecting a person from inflammation. The authors of a 2019 review note that the protective features of HDL depend not only on how much HDL is present but also on the way it behaves in the body.
A 2016 research
Meanwhile, a 2017
While researchers continue to investigate this field, experts still recommend focusing on managing the known risks for cardiovascular disease, including reducing LDL levels.
The first step to healthy cholesterol levels is for people to take a test and discuss the results with a doctor, who will also consider their individual risk factors.
The CDC advises most adults to have a cholesterol test every
Cholesterol tests measure the amount of different cholesterols in mg/dL. Most tests show HDL, LDL, and total (serum) cholesterol. To find a total cholesterol score, a doctor will add together a person’s HDL and LDL cholesterol levels and
|Total cholesterol||Below 200 mg/dL|
|HDL “good” cholesterol||60 mg/dL or above|
|LDL “bad” cholesterol||Below 100 mg/dL|
|Triglycerides||Below 150 mg/dL|
However, various factors will affect what is healthy for each person. A doctor will work with the individual to make a plan for maintaining or establishing suitable levels.
For most people, current guidelines recommend maximizing HDL levels, preferably through lifestyle measures. To achieve and maintain moderate levels, experts recommend:
- having regular cholesterol tests
- eating a balanced diet rich in fruits, vegetables, whole grains, and lean protein
- limiting the intake of saturated and trans fats, processed foods, and added salt and sugars
- exercising regularly
- maintaining a moderate weight
- avoiding or quitting tobacco smoking
- limiting alcohol intake
- managing stress, where possible
7–9hours sleep at bedtime
If a person’s HDL levels are unusually high, a doctor may recommend genetic or other testing to assess their risk of heart disease. Specific medications can address high cholesterol levels due to inherited genetic changes.
If a doctor prescribes medication, the person should take it as directed. If they wish to stop using the drug, they should first speak with a doctor. The person may also need support for other health conditions, such as diabetes or high blood pressure.
Cholesterol is an important indicator of heart disease risk. Doctors recommend aiming for high levels of HDL cholesterol and low levels of LDL cholesterol. HDL cholesterol is beneficial as it helps remove LDL cholesterol from the body.
In some cases, however, a person may develop very high levels of HDL cholesterol, or it may behave in ways that are not beneficial. Scientists are currently investigating how and why this might happen.
Meanwhile, experts continue to recommend focusing on minimizing LDL and maximizing HDL levels, preferably through lifestyle measures but also with medication, where necessary.