When HDL is high (and too high)
Stefanie Worwa, OMS-IV Stefanie Worwa, OMS-IV

When HDL is high (and too high)

For decades, HDL cholesterol has been dubbed the “good cholesterol,” and LDL cholesterol the “bad cholesterol.” In some ways this is true - a high number of LDL particles results in cholesterol build-up, whereas HDL particles aid in cholesterol excretion. Elevated HDL has been associated with a decreased risk of heart disease in several population studies, and so the thought that more HDL is always better has become a pervasive part of medical lore. However, as with most things in medicine, the reality appears to be much more nuanced. Recent studies demonstrate that a high HDL may not always decrease our risk for heart disease and raising it may not improve our heart health. So, what is the optimal level of HDL? Can it still be considered “good cholesterol”? And can it get too high that it is no longer protective?

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