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High HDL cholesterol is good
Cholesterol…the lower the better, right? Not true when talking about high-density lipoprotein (HDL) cholesterol. Often referred to as the “good” cholesterol, your HDL level is the one cholesterol number you want to remain high.

“HDL tends to work as a cleaning agent, carrying the harmful low-density lipoprotein (LDL) cholesterol away from the arteries and back to the liver, where it’s passed from the body,” explains Palmetto Health Heart Hospital cardiologist Dr. Joe Hollins.

“It also may remove excess cholesterol from plaque in the arteries, therefore slowing plaque buildup. So, the more bad LDL cholesterol you have, the more HDL cholesterol you need.”

Not all HDL is created equal. There are five types of HDL, and one is especially helpful in lowering the risk of heart attack. A conventional cholesterol blood test can measure HDL and LDL to provide a total cholesterol level, although it can’t fully predict your health risks. Standard tests measure HDL as a whole. An advanced lipid test can measure important cholesterol subclasses, such as HDL2B, which is particularly efficient at clearing arteries.

From a routine blood draw, Palmetto Health cardiologists can discover individualized indicators of a patient’s cardiovascular health.

The recommended HDL levels differ between men and women because HDL cholesterol levels appear to be particularly important for a woman’s health as she goes through puberty, child-birth years and then menopause.

Current recommendations for men are an HDL level of at least 40 milligrams per deciliter (mg/dL). Recently, researchers increased their recommendation for females from an HDL level of 45 to at least 50 mg/dL for maximum health benefits.

“Fortunately, many of the lifestyle habits that promote HDL cholesterol also reduce LDL cholesterol, such as getting adequate amounts of exercise and eating a heart-healthy diet,” Hollins says.

Some ways to increase your HDL:
• Eat a diet high in monounsaturated fat to increase your level of “good” HDL cholesterol. Consuming monounsaturated fat also can reduce levels of LDL cholesterol and triglycerides.
• Reduce your triglyceride level by avoiding white starchy foods, using sugar and alcohol sparingly, controlling diabetes, and exercising regularly.
• Consume phytosterol-rich foods such as soybeans and flaxseed. Studies show that phytosterols have a positive impact on cholesterol levels, although scientists are still trying to understand exactly how this occurs.
• Don’t smoke. Smoking dramatically decreases HDL levels.
• Exercise regularly.
• Drink alcohol only in moderation.
• Take medication regularly. When lifestyle changes are not enough to raise HDL levels, medication such as nicotinic acid or other cholesterol reducing drugs may be prescribed.

“Everyone has a unique set of risk factors and treatment must be customized to individual needs,” Hollins says. “Research proves that adequate HDL cholesterol levels have a protective effect on cardiovascular health. Not only can low HDL be linked to a higher risk of death from coronary artery disease and stroke, but studies show that healthy HDL levels in the elderly also can help preserve brain cell function and protect against mental decline.”