HDL Cholesterol

The normal reference range for HDL Cholesterol is Above 1.0 mmol/L in men and above 1.3 mmol/L in women is considered protective. Lower levels raise cardiovascular risk. Very high HDL (above ~2.3 mmol/L) is not necessarily extra protection and is occasionally genetic.. Reference ranges may vary between laboratories, so always consult your healthcare provider for interpretation.

Higher levels of HDL are protective against heart disease, while low levels indicate cardiovascular disease risk.

Higher HDL is usually favourable and is raised by regular aerobic exercise, weight loss, moderate alcohol intake, and oestrogen (so women typically run higher than men). Some people have genetically high HDL. Note that extremely high HDL does not provide additional heart protection and, in rare genetic forms, may not be protective at all.

Low HDL is one of the features of metabolic syndrome and is strongly associated with cardiovascular risk. Common causes include type 2 diabetes and insulin resistance, central obesity, physical inactivity, smoking, a diet very high in refined carbohydrates, high triglycerides, and certain genetic conditions. Some medications (anabolic steroids, some beta-blockers) also lower HDL.

HDL is reported as part of a fasting lipid panel. Healthy adults are screened every 5 years from around age 45 (earlier with risk factors or family history, and from 35 for Aboriginal and Torres Strait Islander people under Australian guidelines). Recheck more often when actively managing cardiovascular risk.