What Is Cholesterol?

Cholesterol is a wax-like substance that plays a crucial role in the human body.¹ It is an integral part of every cellular membrane and is a precursor to various hormones. Cholesterol is naturally lipophilic, meaning it dissolves and is attracted to fats instead of water.² As such, cholesterol is carried through the bloodstream as “lipoproteins” after being packed together with proteins.

What Is HDL Cholesterol? 

HDL stands for high-density lipoprotein and is one of the five main types of lipoproteins in the body.³ HDL cholesterols are often known as the “good” cholesterol because of their cardioprotective property.⁴ They play a role in transporting cholesterol from the rest of the body back to the liver where it is removed. As such, higher levels of HDL cholesterol are known to prevent atherosclerosis, the process of arteries hardening from the build-up of cholesterol plaques.⁵

What Is a Healthy Level of HDL Cholesterol? 

The standard HDL cholesterol levels according to ATP III are as follows:⁶ 

As low HDL cholesterol levels are associated with increased risk of cardiovascular disease, it is optimal to HDL cholesterol levels above 60 mg/dL.

What Do I Do If I Have Low HDL Cholesterol?

Low HDL cholesterol is one of the risk factors used to calculate 10-year risk of ASCVD.⁶ It can be caused by many different factors, but is usually associated with causes related to insulin resistance (eg, obesity, physical inactivity, type 2 diabetes mellitus, elevated triglycerides). Other possible causes include cigarette smoking, high intake of carbohydrates (>60% of calories), and taking certain drugs (eg, beta-blockers).

Guidelines recommend that individuals with low HDL levels should primarily focus on achieving target goals for LDL cholesterol levels by following appropriate lifestyle and pharmaceutical approaches.⁶ When LDL cholesterol goals are reached, those with metabolic syndrome are recommended to lose weight and increase physical activity. In cases of isolated low HDL cholesterol levels, where only HDL levels are not optimal, medications to raise HDL levels may be considered, such as fibrates and nicotinic acid. 

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