HDL cholesterol: everything you need to know about good cholesterol

2023-07-21 16:20:05

Definition: what is cholesterol?

From a scientific and simplified point of view, cholesterol is a sterol (form of polycyclic alcohol) formed by 27 carbon atoms. According to more practical considerations, cholesterol belongs to the family of lipids that is to say fats. He can be provided by food (in meat, eggs, cheese, butter) or produced endogenously by the body. Cholesterol is insoluble in liquids and in fact, it circulates in the blood network without mixing.

Cholesterol must couple with a protein that serves as a boat to trace its route through the body. We talk regarding lipoprotein. Whichever transport protein it pairs up with, the cholesterol remains the same. Contrary to popular belief, there are therefore not several types of cholesterol but different cholesterol transport proteins. These macromolecules are two in number:

  • THE High Density Lipoprotein (HDL) or high density lipoproteins which carry so-called “HDL” cholesterol.
  • THE Low Density Lipoprotéin (LDL) or low density lipoproteins which carry LDL cholesterol.

LDL or HDL: what is the good cholesterol?

This is not new, cholesterol has sometimes the bad and sometimes the good role. But this popular idea is not contextualized. In reality, cholesterol is necessary for the body (not to say downright vital). And yes, cholesterol is an essential constituent of our cells. It is the precursor to steroid hormones. It also contributes to the production of substances such as vitamin D. Finally, this lipid is part of the composition of bile.

Cholesterol only becomes harmful if it is absorbed in too large quantities daily through food or if the lack of physical activity slows down your metabolism. In addition, it is necessary to respect a balance in the type of fat consumed : THE saturated fatty acids tend to promote cholesterol deposits in the arteries while regular consumption ofunsaturated fatty acids (omega 3, 6 and 9) is associated with a marked reduction in the risk of cardiovascular events.

LDL cholesterol is “bad”

The LDL cholesterol is viewed as the “bad cholesterol“. It actually corresponds to the cholesterol which circulates from the liver and the intestine to our cells thanks to the LDL lipoproteins. It is perceived as harmful because when there is too much cholesterol which migrates from the liver and the intestine to our cells, the latter is then not recovered and brought back to these organs by the LDL lipoprotein (which is completely overwhelmed). The risk is then that the residual cholesterol accumulates in the blood vessels leading to the formation of atheroma plaques. That’s what we call atherosclerosis. Such a phenomenon reduces the light of our arteries increasing the risk of cardiovascular accident.

Why is HDL cholesterol “good”?

On the other hand, the HDL cholesterol is viewed as the “good cholesterol“. Coupled with its HDL lipoprotein, its role is to recover the excess cholesterol in the blood vessels or accumulated in our organs. The HDL lipoproteins then take the cholesterol to the liver where it is eliminated. HDL cholesterol therefore allows a real cleaning of our blood vessels. It prevents the formation of atherosclerotic plaques on the artery walls and reduces cardiovascular risks.

HDL cholesterol level analysis: how does this blood test take place?

The HDL cholesterol test is carried out within the framework of a lipid profile prescribed by your doctor. It is performed in Medical analysis laboratory requiring a venous blood sampling.

The examination must be carried out with an empty stomach. This means not eating or drinking anything (except water) for the preceding 12 hours. It is also advisable not to drink alcohol 48 hours before the blood test.

This blood test is generally performed at the level of the bend of the elbow. She is almost painless et fast. It is nonetheless unpleasant for many patients. If you tend to turn pale at the sight of a syringe, don’t hesitate to ask for the blood sample to be taken while lying down (avoid looking at the injection).

You can also perform this analysis at your home, if you are unable to travel.

Once collected, the blood sample is then analyzed to measure:

  • the HDL cholesterol level ;
  • the LDL cholesterol level ;
  • the total cholesterol level ;
  • the triglyceride levels.

HDL cholesterol: what is the right level?

The right HDL level

The HDL cholesterol level must be greater than 0.4 g/L. If you are low in HDL cholesterol, you should see a doctor. Generally, this too low rate is associated with other lipid abnormalities affecting LDL cholesterol and triglycerides.

What is the correct HDL/LDL ratio?

If your HDL cholesterol level (good cholesterol) is too low, then your LDL cholesterol level (bad cholesterol) may conversely be excessive. Your LDL cholesterol level should be less than 1.6 g/L. Return to your doctor if you have too much LDL cholesterol.

How to interpret the total cholesterol level?

The calculation of total cholesterol takes into account the HDL cholesterol level and the LDL cholesterol level. It is considered thatit must be less than 2g/L. The analysis of total cholesterol is however not exhaustive, it is also important to know precisely the levels of LDL, HDL as well as the total cholesterol/HDL ratio. This comprehensive report measures cardiovascular risk. It is used less and less. However, it is still considered that beyond 4.0 there is a significant arterial risk.

Triglycerides: what are the normal values?

Finally, the triglyceride level must be less than 1.5 g/L. Otherwise, you should consult your doctor.

Low HDL cholesterol: why? What to do ?

A low HDL cholesterol level (less than 0.4 g/L) is often the sign of a hypocholesterolemiathat is to say of a cholesterol deficiency. Rare, this lack of cholesterol can be linked to:

  • a malnutrition (overweight, obesity, malnutrition, unbalanced diet…) ;
  • the sedentary lifestyle ;
  • l’high blood pressure;
  • the diabetes ;
  • the smoking;
  • l’atherogenic hyperlipoproteinemia;
  • a genetic abnormality ;
  • a cholesterol malabsorption ;
  • the taking progestogen drugs in women;
  • pathology such as cancera hyperthyroidisma Hepatic insufficiency ;
  • a depressive state.

A low HDL cholesterol level is a cardiovascular risk. If the HDL level is low, the cholesterol remains in the bloodstream and accumulates until it causes atheroma plaques on the walls of the arteries and gradually clogs them.

Treatment varies depending on the cause of the hypocholesterolemia. It can go through:

  • The management of the causative disease ;
  • Ofs hygiene and dietary measures such as a balanced diet, regular physical activity and quitting smoking and alcohol.

It should be noted that some lipid-lowering drugs like the statins can moderately increase HDL cholesterol levels.

High HDL cholesterol level: a cardioprotective effect

And high HDL cholesterol, higher than 0.6 g/L, is perceived as favorable for health. This high rate might be associated with a cardioprotective effect. It is common in sports people. Indeed, physical activity would increase HDL cholesterol levels and decrease LDL cholesterol levels.

A high HDL cholesterol level must nevertheless be analyzed with regard to the other results of the lipid profile. In addition, this rate can be artificial and explained by the taking of certain drugs including hypolipidemics.

How to lower bad cholesterol and raise the good?

It is possible to restore the balance of good and bad cholesterol naturally (although some patients are constitutional hypersecretors of cholesterol (genetic cause)). A balanced diet and an regular physical activity lower LDL cholesterol and raise HDL cholesterol.

Prioritize high fiber foods (fruits, vegetables, oilseeds, legumes and whole grains) and unsaturated fatty acids (especially omega 3) such as fatty fish and virgin oils. Integrate daily antioxidant foods which help fight once morest the oxidation of cholesterol as well as unprocessed foodstuffs and which have low glycemic indices. Limit your consumption of alcohol, tobacco, viandes grasses and charcuterie.

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