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All about HDL cholesterol levels

16 September 2026|6 min read
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By BloedCheckup

Your blood test results often show an LDL value next to an HDL cholesterol level. HDL is called the 'good' cholesterol, but a high value is no guarantee of healthy blood vessels. Below you can read what you can actually deduce from this measurement.

What is HDL cholesterol?

HDL stands for high-density lipoprotein. It is a group of particles that transport cholesterol through the blood and are involved in recycling it back to the liver. There, cholesterol can be further processed. When we talk about HDL cholesterol, we mean the amount of cholesterol contained in these particles.

Cholesterol is a building block for cells and hormones, among other things. It must be transported because it doesn't dissolve in blood. HDL and LDL have different roles in this process. LDL transports cholesterol to tissues; prolonged high LDL can contribute to fat accumulation in the artery wall.

What does your HDL level indicate?

HDL is used as part of the assessment of your risk of cardiovascular diseases. A low value can be associated with a less favorable risk profile but is not a diagnosis. Also, a high value does not alone determine how healthy your blood vessels are.

Result

What does this mean?

Low HDL

Reason to look at the full lipid profile and other risk factors.

HDL within reference values

Also assess LDL, triglycerides, and your personal risk.

Frequently asked questions about HDL cholesterol

Is HDL the same as the cholesterol ratio?

No. HDL is a measured cholesterol value. The ratio is a calculation: total cholesterol divided by HDL.

Should I primarily try to raise my HDL?

The goal is a lower risk of cardiovascular diseases, not just a higher HDL number. Healthy living and assessing, among other factors, LDL, blood pressure, and smoking habits are important.

Read also

Remarkably high HDL

Not automatically extra protection. Discuss the value in conjunction with the rest of your results.

Labs can use different reference limits, including based on gender. The boundary on your report helps in interpreting the measurement but does not replace the assessment of your personal risk.

Is a higher HDL always better?

No. The statement 'the higher, the better' is too simplistic. Very high HDL levels have not always proven beneficial in research. Simply increasing the amount of HDL in the blood is not the same as lowering the risk of cardiovascular diseases.

A high HDL does not negate a high LDL. In cholesterol treatment, the emphasis is also on LDL or non-HDL and the total risk. Read more about .

What can cause low HDL?

Genetics and lifestyle can both play a role. Low HDL occurs, for example, in smoking, overweight, and lack of exercise. Other conditions, certain medications, and elevated triglyceride levels can also be associated.

It is not always possible to identify a single cause. Therefore, have an abnormal result assessed with your other cholesterol levels. Do not adjust medications yourself to change your HDL.

What can you do yourself?

Focus on your heart health as a whole, rather than just a higher HDL number:

  • Exercise regularly in a sustainable way.

  • Stop smoking.

  • Eat a varied and fiber-rich diet, with more unsaturated instead of saturated fats.

  • Work towards a healthy weight if needed.

Do not start drinking alcohol to raise your HDL. Any increase in HDL does not negate the health risks of alcohol. Discuss with your doctor which changes can make the most difference for you.

Cholesterol ratio and non-HDL

You calculate the cholesterol ratio by dividing total cholesterol by HDL. Non-HDL is calculated by subtracting HDL from total cholesterol. They are different numbers that provide additional information.

A ratio is not a complete risk calculation. Age, blood pressure, smoking habits, diabetes, and previous cardiovascular diseases remain important. A favorable ratio does not mean you can ignore a high LDL.

Having your HDL measured

HDL is often measured together with total cholesterol, LDL, and triglycerides. Check to see which combination is associated with the chosen test.

You do not need to fast by default for cholesterol measurement. When combined with other tests or a specific follow-up measurement, preparation instructions may apply. Follow the information you receive with your order.

Sources

  • HEART UK — High HDL cholesterol

  • Hartstichting — Cholesterol

  • Guideline database — Fasting blood sampling for CVRM

Can a high HDL accompany a high LDL?

Yes. Both values can be elevated. A high HDL does not neutralize a high LDL.

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