HDL vs LDL Cholesterol – The Good, the Bad, and the Ugly

HDL vs LDL cholesterol

When you have your annual physical, you’re often concerned about your cholesterol. Most people only know whether they have “high cholesterol” or “good cholesterol”, but in truth, doctors look at four different numbers. These are HDL, LDL, triglycerides, and total cholesterol levels. It’s important to understand the differences in HDL vs LDL cholesterol as this will help you make better decisions when it comes to diet and nutrition.

The Four Parts of the Lipoprotein Profile

The medical term for a cholesterol test – the one you receive during your annual checkup – is “lipoprotein profile”. The goal is to measure not only your cholesterol levels, but also the concentration of triglycerides in your bloodstream. There are four parts to the lipoprotein profile.

  • Total Cholesterol – This is the total amount of cholesterol in your bloodstream as determined by your bloodwork. It’s the combination of both HDL and LDL, and it can say a lot about your health.
  • HDL Cholesterol – This stands for high-density lipoprotein, which is considered “good” cholesterol. The higher the number, the lower your risk of developing heart conditions.
  • LDL Cholesterol – On the other hand, this stands for low-density lipoprotein, which is known as the “bad” cholesterol. The higher this number, the higher your risk of developing heart conditions.
  • Triglycerides – Triglycerides are fats that circulate in the blood. When you consume alcohol, sugar, and excess calories, your body converts these to triglycerides, which are then stored in fat cells throughout your body. High triglycerides can allude to many health conditions, including obesity, diabetes, and potential arterial and heart issues.

HDL vs LDL Cholesterol: Understanding HDL

HDL vs LDL cholesterolThe two types of cholesterol are very different, and you should pay close attention to your test results. While high cholesterol is often considered a bad thing, you’ll want to see high HDL numbers. HDL is responsible for removing the more dangerous LDL from your body, which keeps it from building up inside your arteries. The American Heart Association says that a level of 60 or more is considered protective against heart disease, while anything less than 40mg/dL for women or 50mg/dL for men is indicative of significant risk. The best way to maintain healthy HDL levels is with a healthy diet and exercise.

Japanese researchers carefully evaluated the effect exercise has on HDL levels. They gathered data from 35 random trials that took place around the world, and they carefully assessed the ways in which exercise impacted HDL. Although the participants engaged in many different types of exercise, the results were clear across the board. Patients who exercised 40 minutes three to four times each week increased their HDL levels by about 2.5 mg/dL, which isn’t a very large gain, but is still significant. What’s more, when you consider that your risk of cardiac events drops by about 2.5% for every mg/dL increase in HDL, that’s a 7% decline in risk just from exercise alone.

The More Dangerous LDL

On the other hand, if your LDL cholesterol is too high according to your test results, this means you’re at an increased risk of cardiac events. LDL cholesterol is the type that builds up in your arteries, and the higher that number climbs, the more likely that you have significant buildup which can lead to arterial blockage. Per the American Heart Association, an LDL number of more than 190mg/dL is considered very high. However, your doctor will also assess your 10-year risk based on your total cholesterol, which considers HDL vs LDL cholesterol and triglycerides to determine your overall risk factors.

If your LDL cholesterol is elevated, and your HDL levels are too low, your doctor will probably ask you to change your diet and lifestyle. However, if you’re above the 190mg/dL threshold, or if your 10-year risk is significant, your doctor will likely also prescribe a medication called a statin. These medications are designed to increase your HDL cholesterol by inhibiting the action of an enzyme called HMG-CoA reductase, which is responsible for producing cholesterol in the liver. Essentially, a statin slows down the production of bad cholesterol.

Total Cholesterol and what You should Know

Simply put, total cholesterol is the measure of HDL vs LDL cholesterol and the way they relate to one another. The ideal total cholesterol number is 200mg/dL or less, though there are cases in which a very high LDL and extremely low HDL could signify a problem, even if your total cholesterol is well below this number. For example, you may have LDL cholesterol levels on the high end of normal at 140 along with low HDL levels at around 35. Although your total cholesterol is still well below the 200mg/dL mark, the individual numbers act as warning signs. That’s why it’s so very important to understand the differences between HDL vs. LDL cholesterol and make the appropriate changes if either result is considered abnormal.

Triglycerides and Risk Factors

You need some triglycerides for good health since your body uses these as a form of energy. However, if you have high triglycerides (over 200), this is indicative of metabolic syndrome, which is the combination of high blood sugar, excess fat around the waist, low HDL, high blood pressure, and high triglycerides. Metabolic syndrome greatly increases your odds of developing heart disease and diabetes, and it also elevates your risk of stroke. The best way to reduce triglycerides in your bloodstream is with a healthy balanced diet and regular exercise, though quitting smoking, reducing your intake of alcohol, and actively losing excess weight can help, too.

The best way to remember the difference between HDL and LDL cholesterol is to remember that the H stands for high, so the higher, the better; Meanwhile, L stands for low, so the lower, the better. If you have concerns about your cholesterol, talk to your doctor so you can come up with a plan for getting your health back on track.