HDL cholesterol

HDL cholesterol (high-density lipoprotein cholesterol, often called "good" cholesterol) is the amount of cholesterol carried in HDL particles, which pick up excess cholesterol and take it back to the liver to be removed.

Also called: HDL-C, high-density lipoprotein cholesterol, good cholesterol.

What it measures

HDL cholesterol is the concentration of cholesterol inside HDL particles, in mg/dL or mmol/L. It's on every standard lipid panel. A low HDL is linked to higher heart risk, and HDL is one of the inputs to risk scores such as PREVENT and QRISK3.

HDL is a marker, though, not a lever. Genetic studies found that people born with HDL-raising gene variants don't have fewer heart attacks, and medicines that raise HDL haven't been shown to prevent them. The 2026 ACC/AHA guideline says niacin should generally be avoided and doesn't recommend fibrates or niacin routinely on top of a statin.

Healthy ranges

The NHS gives a healthy HDL as above 1.0 mmol/L for men and above 1.2 mmol/L for women. Higher isn't always better: in one study of over 116,000 Danish adults, death rates were lowest around 1.9 mmol/L (73 mg/dL) in men and 2.4 mmol/L (93 mg/dL) in women, and higher at very high levels. The authors said the finding needs confirming.

What raises and lowers it

• Raises it: regular physical activity, not smoking, losing excess weight, and choosing unsaturated fats over saturated and trans fats.
• Lowers it: smoking, excess weight, inactivity, and diets high in sugar and refined carbohydrates. A low HDL often comes with high triglycerides.

A good HDL doesn't cancel out a high LDL. Treatment decisions are based mainly on LDL or non-HDL cholesterol and your overall risk.

Deeper reading

Related terms

• ApoB
• LDL cholesterol
• Lipoprotein(a)
• Non-HDL cholesterol
• PREVENT risk calculator
• Triglycerides
• VLDL cholesterol
• All glossary terms

Frequently asked questions

What is a good HDL cholesterol level?

At least 40 mg/dL (1.0 mmol/L) for men and 50 mg/dL (1.3 mmol/L) for women by US guides, with 60 mg/dL (1.5 mmol/L) or more generally considered protective. The NHS says above 1.0 mmol/L for men and above 1.2 mmol/L for women.

Can HDL cholesterol be too high?

Very high HDL doesn't seem to be extra protective. A large Danish study found higher death rates in men with HDL of 3.0 mmol/L (116 mg/dL) or more and women with 3.5 mmol/L (135 mg/dL) or more, though the authors said this needs confirming.

Does raising HDL lower heart risk?

Not on its own. People with genes that raise HDL don't have fewer heart attacks, and HDL-raising drugs haven't prevented them. Exercise, not smoking and weight loss help the heart in many ways, and a higher HDL is one sign of that.

Sources

• MedlinePlus: HDL, the "good" cholesterol
• NHS: Cholesterol levels
• Blumenthal RS, Morris PB, et al. 2026 ACC/AHA Guideline on the Management of Dyslipidemia. J Am Coll Cardiol. 2026;87(19). Also in Circulation, doi:10.1161/CIR.0000000000001423.
• Voight BF, et al. Plasma HDL cholesterol and risk of myocardial infarction: a mendelian randomisation study. Lancet. 2012;380:572–580.
• Madsen CM, et al. Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women. Eur Heart J. 2017;38:2478–2486.