Medical questions & health advice by board certified doctors
"Should my HDL cholesterol be higher than my LDL?"
Which one should be higher? Should they be equal?
Your confusion is understandable. This is a confusing concept for many people and the goals for having good cholesterol control continue to change. First, let me explain briefly what cholesterol is and why it’s important at all. Then I’ll talk a little about the different types of cholesterol and finally explain what the numbers ought to be. Cholesterol is one of the basic building blocks of cell membranes and is critical for constructing many hormones. Unfortunately, cholesterol has other roles that are more harmful. The reason that so many doctors care about it is because cholesterol is involved in plaques in arteries and the disease process that causes strokes and heart attacks. This is where good cholesterol and bad cholesterol come into play. First, let me say a little about the “good” form of cholesterol, known as high-density lipoprotein (HDL) cholesterol. HDL works in a number of ways, but importantly it helps transport other cholesterol particles from tissues and blood back to the liver, including helping to remove “bad” or low-density liopoprotein (LDL) cholesterol from plaques in arteries. High concentrations of LDL cholesterol are associated with plaque formation in the arteries, and it is these plaques that can narrow arteries or rupture and cause heart attacks and strokes. The levels of cholesterol are usually measured in total cholesterol, LDL, HDL, and triglycerides. If you are healthy and do not have any medical problems the current guidelines suggest a goal LDL below 130mg/dL, but if you have certain medical problems such as heart disease,diabetes or strokes the goal can be as low as 70. For HDL the goal is more straight forward 45mg/dL and the higher the better. So though it would excellent to have an HDL level that’s higher than the LDL, this is frequently not possible. Shooting for as low and LDL level and possible and a high an HDL level as possible are the goals. Your primary care physician or cardiologist can best discuss your results to help you meet your goals. Good luck!
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