When it comes to cholesterol and health, general recommendations are to aim for lower cholesterol levels. But not all types of cholesterol are harmful. High-density lipoprotein cholesterol provides a protective effect against heart disease, and a high HDL level is considered a good thing. When trying to manage cholesterol, the first step is to have a cholesterol test so your physician can review the numbers and make recommendations if levels of any type is too high.
HDL Cholesterol
Cholesterol cannot dissolve in the blood, so it must be transported through the body by special carriers. One type of carrier is low-density lipoprotein, which is considered the bad kind, because it takes cholesterol to be stored in the body. When LDL levels get too high, plaque can build up along the blood vessel walls and cause a condition called coronary artery disease. The other main type of carrier is HDL, which is the "good" kind, because it takes LDL to be excreted. If your total cholesterol count is under 200 mg/dL, but your HDL levels are under 40 mg/dL, your risk for heart disease is higher than someone with a low total cholesterol count but high HDL count, says the Texas Heart Institute. Given this, all adults should aim to raise HDL levels to at least 60 mg/dL or higher.
Benefits
HDL is considered "good" because it picks up LDL in the blood and carries it to the liver so it can be removed from the body. Having a high HDL level can slow down the buildup of plaque along the artery walls. When controlling total cholesterol levels, the goal is to raise the HDL level so there is a lower proportion of LDL cholesterol in the blood.
Considerations
Because HDL cholesterol protects against heart disease, the goal is to raise the level as high as you can. Aiming for an HDL level of 60 mg/dL is just a guideline and if you can get it even higher, all the better. A physician will need to review your individual overall health to determine the actual risk for heart disease. The Cleveland Clinic suggests that patients with a total cholesterol level of up to 240 mg/dL, with a high HDL level, may not be at risk for disease. Because each case is different, always talk with a physician about your high HDL levels, as genetic conditions and illnesses that cause dangerously high levels of all types of cholesterol.
HDL Ratio
You can use your HDL level and total cholesterol level to come up with a ratio that can also help predict the risk for heart disease. To calculate the ratio, divide the total cholesterol count by the HDL count. For men, a ratio of 5 signifies an average risk for heart disease; those with a ratio of 3.4 have about half the average risk; and men with a ratio of 9.6, have almost double the average risk. Women tend to have higher HDL levels, so for them, a ratio of 4.4 signifies average risk; 3.3 is about half of the average; and a ratio of 7 indicates almost double the risk.
