HDL cholesterol levels

HDL cholesterol is a high-density lipoprotein, commonly known as "good cholesterol" because it is responsible for the storage and excretion of cholesterol, which has been linked to a lower risk of heart attack or stroke.

HDL cholesterol (high-density lipoprotein) is a lipoprotein from the chylomicron group whose functions include transporting lipids such as phospholipids, triglycerides, or cholesterol. It differs from other lipoproteins like LDL due to its higher density, a result of having a greater amount of protein in its composition.

The main function of HDL is to transport cholesterol from peripheral tissues to the liver, playing a role in lipid biodistribution. It is commonly known as "good cholesterol" due to its anti-atherogenic and anti-inflammatory properties, thanks to its uptake and return to the liver of cholesterol stored in the foam cells of atherosclerotic plaques. This way, it reduces plaque size and its associated inflammation, lowering the risk of atherosclerosis, a precursor to myocardial infarction, transient ischemic attack, and stroke.

HDL cholesterol is fundamental for the body's lipid balance, as it allows for the elimination of excess cholesterol, preventing its accumulation in the arteries and contributing to the prevention of cardiovascular diseases. It is well-established that elevated HDL levels (> 40 mg/dL) are associated with a lower risk of coronary heart disease and are believed to play a role in predicting cardiovascular risk.

HDL cholesterol levels can vary for different reasons. Genetic factors are among those influencing the levels of this lipoprotein. HDL levels can be partly determined by genetic variants affecting lipid metabolism, such as certain polymorphisms in genes related to lipoprotein lipase or apolipoprotein A1. Compared to genetically determined HDL metabolism abnormalities, low HDL-C levels occur much more frequently in patients with metabolic syndrome or diabetes mellitus. Low HDL-C levels are also associated with systemic inflammation, for example, with smoking, chronic inflammatory diseases, or chronic kidney disease.

Some established HDL cholesterol levels based on their relationship to cardiovascular disease risk are mentioned below:

• Less than 40 mg/dL in men = low HDL (increased risk).
• Less than 50 mg/dL in women = low HDL (higher risk)
• 40 to 59 mg/dL = Higher is better
• 60 mg/dL and above = high HDL (lower risk)

To raise HDL levels, it's advisable to make lifestyle changes, such as improving diet, exercising regularly, avoiding tobacco use, and reducing alcohol consumption. In some cases, medications may be necessary, but a doctor should always indicate the most suitable option. Having elevated HDL levels is generally not bad and, in fact, is associated with better protection against cardiovascular diseases. On the other hand, low HDL levels are a risk factor for developing atherosclerosis and heart disease, and it's particularly concerning in women, as this type of alteration can become more frequent as they age.

Regarding normal HDL levels, a level of 60 mg/dL or higher is considered ideal, as it's associated with a lower cardiovascular risk. However, it's important not to focus solely on the HDL level but to consider the the ratio between HDL and LDL, as a proper balance of both lipoproteins is key for cardiovascular health.

If you're wondering why HDL cholesterol drops, lack of physical activity, obesity, a diet high in saturated and trans fats, and tobacco use are factors that can reduce HDL levels. Additionally,