However, although low levels of HDL predict increased cardiovascular risk, particularly in healthy individuals with no history of cardiovascular events, the relationship between HDL and CHD risk is complex, with HDL-C and cardiovascular disease having a nonlinear relationship. For example, research found that HDL levels above approximately 60 mg/dL showed no further improvement in prognosis, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk and IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering) studies showed that very high levels of HDL may actually be associated with an increased risk of atherosclerotic disease. [5, 6, 2]
HDL is plasma’s smallest and densest lipoprotein. The major apolipoproteins of HDL are apo A-I and apo A-II, the alpha lipoproteins. An elevated concentration of apo A-I and apo A-II, known as hyperalphalipoproteinemia (HALP), is associated with a lower risk of CHD. Conversely, hypoalphalipoproteinemia increases the chances of CHD development. [2] HALP generally does not produce any unusual clinical features (although corneal opacity has been associated with the condition), and it should not be considered a disease entity but rather a fortuitous condition that can increase longevity because of the related decrease in CHD incidence. [9]
HDL is plasma’s smallest and densest lipoprotein. The major apolipoproteins of HDL are apo A-I and apo A-II, the alpha lipoproteins. An elevated concentration of apo A-I and apo A-II, known as hyperalphalipoproteinemia (HALP), is associated with a lower risk of CHD. Conversely, hypoalphalipoproteinemia increases the chances of CHD development. [2] HALP generally does not produce any unusual clinical features (although corneal opacity has been associated with the condition), and it should not be considered a disease entity but rather a fortuitous condition that can increase longevity because of the related decrease in CHD incidence. [9]

When your body has too much LDL cholesterol, the LDL cholesterol can build up on the walls of your blood vessels. This buildup is called “plaque.” As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing blocks blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina (chest pain) or a heart attack.
While it has been proven via multiple studies that elevated levels of low-density lipoprotein (LDL) contribute to the development of atherosclerosis, high-density lipoprotein (HDL) is widely thought to have atheroprotective effects. Results from multiple epidemiologic studies of healthy populations (most importantly, from the Framingham Heart Study) have given rise to the idea that high HDL levels protect against coronary heart disease (CHD). Patients with known CHD have been found to have lower levels of HDL. [1, 2]
Kimchi, a Korean fermented side dish commonly made from cabbage, radish or cucumber, is quickly gaining a following for its many health benefits. Kimchi is high in fiber and—because it's fermented—is loaded with good bacteria that help keep your gut healthy. Kimchi contains bioactive compounds that lower cholesterol by blocking cholesterol from being absorbed into the bloodstream. The good bacteria produced during fermentation also help lower cholesterol. Kimchi and sauerkraut are usually pretty high in sodium, so watch your portions if you're watching your salt intake.
Niacin (vitamin B3) is believed to block cholesterol production in the body. Although niacin in prescription supplement form appears to be most effective in increasing HDL, it may have side effects such as flushing, itching, and headache, so you may want to consider adding niacin-containing foods to your diet first. Niacin is found in high concentrations in crimini mushrooms, chicken breast, halibut, tomato, romaine lettuce, enriched bread, and cereals.
Barley, oatmeal and brown rice have lots of soluble fiber, which has been proven to lower LDL cholesterol by reducing the absorption of cholesterol into your bloodstream. Try switching out your regular pasta for the whole-grain version, or use brown rice instead of white. To give an added cholesterol-busting kick, top your morning oatmeal with high-fiber fruit like bananas or apples.
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Cholesterol is carried through the bloodstream attached to two different compounds called lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is commonly known as the “bad” cholesterol because it transports cholesterol from the liver throughout the body, and potentially allows it to be deposited in artery walls. HDL, known as the “good cholesterol,” picks up cholesterol from the blood and delivers it to cells that use it, or takes it back to the liver to be recycled or eliminated from the body.
I had a minor stroke in October 2017, since then I have gained 15 pounds. I have tried everything (exercising included),, and I am not loosing any weight . I take 1 pill everyday to lower my cholesterol. I hate this weight around me, and is mentally affecting me as I have been slim for last 8 years. None of my clothes fit me … Any suggestions will be appreciated…
So far, these studies have been disappointing, to say the least. The first major trial (concluded in 2006) with the first CETP inhibitor drug, torcetrapib (from Pfizer), not only failed to show a reduction in risk when HDL was increased but actually showed an increase in cardiovascular risk. Another study with another CETP inhibitor - dalcetrapib (from Roche) - was halted in May 2012 for lack of effectiveness. Both of these related drugs significantly increased HDL levels, but doing so did not result in any clinical benefit.
Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
Total cholesterol is a measure of the total amount of cholesterol in your blood, which includes HDL, LDL and triglycerides. However, total cholesterol is mainly made up of LDL or “bad” cholesterol. Having high levels of low-density lipoprotein or LDL can lead to plaque buildup in your arteries, increasing your likelihood for heart disease and stroke. LDL also raises your risk for a condition called peripheral artery disease, which can develop when plaque buildup narrows an artery supplying blood to the legs. The good news is that the higher your HDL level, the lower your body’s LDL level or “bad” cholesterol.
Total cholesterol is a measure of the total amount of cholesterol in your blood, which includes HDL, LDL and triglycerides. However, total cholesterol is mainly made up of LDL or “bad” cholesterol. Having high levels of low-density lipoprotein or LDL can lead to plaque buildup in your arteries, increasing your likelihood for heart disease and stroke. LDL also raises your risk for a condition called peripheral artery disease, which can develop when plaque buildup narrows an artery supplying blood to the legs. The good news is that the higher your HDL level, the lower your body’s LDL level or “bad” cholesterol.

My Dr has ldl normal range as 50-100. I wish I had your ldl. I have a family history w Mom for higher cholesterol. No clue what my dads was. I think I would get another Dr opinion bc what dr tells me for my numbers compared to yours, he would probably praise you. Don’t get sucked into one dr trying to put you on statins w those numbers. Statins have their negative side for you too. I know it’s only my opinion but with your numbers, I think your doing great!


While the world of wellness endlessly touts of benefits of anti-inflammatory foods, who knew eating these could kill two birds with one stone by also improving your cholesterol? Blueberries are rich in anthocyanins, the phytochemical that gives this berry its dark blue pigment and are essential to overall heart health through enhancing anti-inflammatory pathways as well as increasing HDL cholesterol levels, according to a study in The American Journal of Clinical Nutrition. One 2013 study found that consuming blueberries in tandem with exercise can increase HDL levels even more than exercise alone. 

If you want to increase the benefits of the fats you eat, work out before you chow down. A study at the University of Missouri found that regular exercise prior to high-fat meals produces a large hike in HDL. I’m not suggesting that your excuse for indulging in high-fat meals ought to be a pre-meal workout, merely that exercise before a meal works to your heart’s advantage.
Obesity results not only in increased LDL cholesterol but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your waist-to-hip ratio is particularly important in determining whether you ought to concentrate on weight loss.
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you’re overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don’t help or if you’re unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
Of course, shifting to a cholesterol-lowering diet takes more attention than popping a daily statin. It means expanding the variety of foods you usually put in your shopping cart and getting used to new textures and flavors. But it's a "natural" way to lower cholesterol, and it avoids the risk of muscle problems and other side effects that plague some people who take statins.

To maintain a healthy body, you should exercise on a daily basis. If you want another specific reason to start exercising or increase your frequency of exercise, it’s your HDL levels. Increased physical activity directly helps raise your HDL cholesterol — just another one of the many benefits of exercise. Vigorous exercise is the best choice for boosting HDL, but any additional exercise is better than none. (2)
There is considerable controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.
Furthermore, in epidemiological studies involving over 100,000 individuals, people whose HDL cholesterol levels are below about 40 mg/dL had a substantially higher cardiac risk than those with higher HDL levels. This is the case even when LDL cholesterol ("bad" cholesterol) levels are low. Higher HDL levels have also been associated with a reduced risk of breast, colon and lung cancer.
Saturated fats. Typical sources of saturated fat include animal products, such as red meat, whole-fat dairy products, and eggs, and also a few vegetable oils, such as palm oil, coconut oil, and cocoa butter. Saturated fat can increase your levels of "bad" LDL cholesterol. But it has some benefits, too — it lowers triglycerides and nudges up levels of "good" HDL cholesterol.
Altering your diet is the easiest way to lower your elevated LDL cholesterol, and should be your first course of action, as every cholesterol-lowering strategy starts with your dietary habits. A balanced diet consisting of fruits, vegetables, whole grains, fish, and various plants will significantly help you lower your LDL cholesterol level. It’s best to limit the amount of red meat, eggs, and dairy you consume. Plant-based diets not only help lower your LDL, but they can also help clear plaque buildup from your arteries.
A study published in February 2016 in the journal PLoS One concluded as much. For nearly 11,000 adults, researchers found that low to moderate alcohol consumption (20 or fewer drinks a week for a man, 10 or fewer for a woman) led to higher levels of HDL cholesterol. It also helped get them to healthier overall cholesterol levels, decreasing triglycerides (blood fats in blood) and lowering LDL cholesterol.

HDL cholesterol is “good” because elevated blood levels have been associated with a lower risk of cardiovascular disease. However, clinical trials with experimental medications aimed at increasing HDL cholesterol levels, so far, have been largely disappointing. HDL researchers have gone back to the drawing board to figure out what it is about HDL that may reduce the risk of heart disease.
I very simply lowered my cholesterol 57 points in 6 month (257 to 200) and my ldl from 158 to 132 by not eating meat. It has now been a year since I stopped eating meat, I cannot exercise due to major surgery but lost 50lbs and will have my cholesterol retested in September for my annual checkup. I’m also planning on going back to the gym soon. High cholesterol runs in my family and I was determined not to go on medication like my mom. I gained 30lbs when I was injured, I did not intend to go back to my weight as a teenager when I stopped eating meat, just lower my cholesterol, that was just a perk. I never deprive myself of food, I eat fish and I don’t miss meat from my diet at all. It was a conscience choice I made to try and lower my cholesterol, no one told me to or advised me but it worked and I’m happy I took the path. Good luck to all and stay healthy!
Other supplements that have been suggested for cholesterol have less evidence of being useful. In the case of red yeast rice, there is a potential danger because it contains a naturally-occurring form of lovastatin, a prescription drug. Garlic has now been shown to be ineffective for lowering cholesterol. Other supplements and food you may see touted include policosanol, coenzyme Q10, green tea, and soy.
Hyperalphalipoproteinemia (HALP) may be familial, including primary (without CETP deficiency) and otherwise (with CETP deficiency), or secondary. [15] Familial HALP (aside from the primary form) is a well-documented genetic form of hypercholesterolemia characterized by a deficiency of CETP, a key protein in the reverse cholesterol transport (RCT) system that facilitates the transfer of cholesteryl esters from high-density lipoprotein (HDL) to beta lipoproteins. Primary HALP is a term used for familial elevated HDL cholesterol levels that are not due to CETP deficiency and for which the cause is unknown. Secondary HALP is due to environmental factors or medications.
HDL is more tightly controlled by genetic factors than are the other lipoproteins (ie, LDL, very–low-density lipoprotein (VLDL), intermediate-density lipoprotein [IDL], chylomicrons). For example, in certain families, especially some families with Japanese ancestry, a genetic deficiency of cholesteryl ester transfer protein (CETP) is associated with strikingly elevated HDL-C levels. [10]
A largely vegetarian "dietary portfolio of cholesterol-lowering foods" substantially lowers LDL, triglycerides, and blood pressure. The key dietary components are plenty of fruits and vegetables, whole grains instead of highly refined ones, and protein mostly from plants. Add margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds.

Avoid Artificial Trans Fats – We all know how delicious fast food, soda, and cookies are, but they present our bodies with so many negative health effects, including bloating, weight gain, lower HDL cholesterol levels, and higher instances of inflammation. Protect your heart health and your HDL cholesterol by avoiding artificial trans fats as much as possible. Indulging once in a while is okay; just make sure that it remains infrequent and in reasonable portions (enjoy ½ cup of your favorite ice cream – not ½ of the carton, for example).
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society
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