What Is HDL Cholesterol?
HDL (high-density lipoprotein) cholesterol is often called "good cholesterol" because HDL particles perform reverse cholesterol transport — picking up excess cholesterol from arterial walls and returning it to the liver.
Higher HDL is associated with lower cardiovascular risk, but the story is more complicated than the "good" label suggests.
HDL: What It Actually Does
HDL particles have anti-inflammatory and antioxidant effects. Low HDL is a strong, independent predictor of cardiovascular events and one of the five criteria for metabolic syndrome.
HDL Reference Ranges
Below 1.0 mmol/L (men) / 1.3 (women): Low. 1.0–1.5 / 1.3–1.5: Borderline. Above 1.5: Adequate. Above 1.9: Protective.
Why HDL Alone Is Incomplete
HDL function matters more than HDL level. Drugs that raise HDL failed to reduce cardiovascular events. This is why assessment has moved toward ApoB and Lp(a) as primary targets.
How to Raise HDL
- Aerobic exercise — most effective modifiable lever
- Smoking cessation
- Reducing refined carbohydrates
- Weight loss
HDL in Context: The Triglyceride/HDL Ratio
The triglyceride/HDL ratio is a useful proxy for small dense LDL and insulin resistance. Ratio below 1.5:1 is generally healthy; above 3:1 suggests insulin resistance.
