Definition

HDL stands for high-density lipoprotein. It's also sometimes called "good" cholesterol. Lipoproteins are made of fat and protein. They carry cholesterol, triglycerides, and other fats, called lipids, in the blood from other parts of your body to your liver.

This article discusses the blood test used to measure the level of HDL cholesterol in your blood.

See also:

Alternative Names

High-density lipoprotein test

How the test is performed

A blood sample is needed.

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

How to prepare for the test

You may be told not to eat or drink anything for 9 - 12 hours before the test.

The health care provider may tell you to stop taking certain drugs before the procedure.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

This test is done to check the level of cholesterol in your blood and to see if you are at high risk for a heart attack, stroke, or other cardiovascular problem. Studies of both men and women have shown that the higher your HDL, the lower your risk of coronary artery disease. This is why HDL is sometimes referred to as "good" cholesterol.

The main function of HDL is to help soak up excess cholesterol from the walls of blood vessels and carry it to the liver, where it breaks down and is removed from the body in the bile.

The laboratory test for HDL actually measures how much cholesterol is in each high-density lipoprotein particle, not the actual amount of HDL in the blood.

Normal Values

In general, your risk for heart disease, including a heart attack, increases if your HDL cholesterol level is less than 40 mg/dL.

An HDL 60 mg/dL or above helps protect against heart disease.

Women tend to have higher HDL cholesterol than men.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Low HDL levels may be a sign that you have an increased risk for atherosclerotic heart disease.

A low HDL level may also be associated with:

Familial combined hyperlipidemia
Noninsulin-dependent diabetes (NIDD)
Use of certain drugs such as anabolic steroids, antipsychotics, beta blockers, corticosteroids, and protease inhibitors

What the risks are

There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)

Special considerations

HDL may be done as part of an overall lipid profile, where "bad" cholesterol (LDL) and triglycerides will also be measured. The combined information gathered from all of these tests may help your risk of heart attack, stroke, and peripheral vascular disease.

Your health care provider may recommend therapy if your risk is found to be high. Regular exercise can increase HDL levels by several points.

References

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486-2497. Updated 2004.

U.S. Preventive Services Task Force. Screening for lipid disorders in adults: U.S. Preventive Services Task Force recommendation statement. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2008 Jun.

U.S. Preventive Services Task Force. Screening for Lipid Disorders in Children. US Preventive Services;Task Force recommendation statement. Pediatrics. 2007;120(1):e215-9.

Semenkovich CF. Disorders of lipid metabolism. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 217.

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