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What is the difference between HDL and LDL cholesterol?
Medically reviewed by Amy Richter, RD, Nutrition — Written by Jo Lewin R.N. — Updated on December 21, 2023
Low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, collects in the walls of the blood vessels, causing them to narrow. High-density lipoprotein (HDL), or “good” cholesterol, moves LDL cholesterol out of the bloodstream.
The two main types of
cholesterol are high-density lipoprotein (HDL) or “good” cholesterol, and low-density lipoprotein (LDL) or “bad” cholesterol. Some cholesterol is needed in the body, but high levels can be dangerous.
Along with smoking and high blood pressure, raised blood cholesterol is one of the
main risk factorsTrusted Source for heart disease. People can reduce their blood cholesterol with a healthful diet, exercise, and medication.
In this article, we look at HDL and LDL in detail, including what makes one good and the other bad, as well as what a person can do to keep levels in check.
HDL vs. LDL cholesterol
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LDL cholesterol is often called bad cholesterol. If there is too much LDL cholesterol in the blood, it builds up in the walls of the blood vessels, causing them to narrow and stiffen.
A buildup of LDL cholesterol reduces blood flow and can increase the risk of
heart attack or
stroke.
HDL or good cholesterol can move LDL cholesterol from the blood to the liver, which breaks it down for disposal as waste. HDL cholesterol is referred to as good cholesterol because it reduces the level of cholesterol in the blood.
Higher HDL levels are
linked toTrusted Source a reduced risk of heart attack and
heart disease.
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What are the ideal ranges of LDL and HDL?
In the United States, cholesterol is measured in milligrams per deciliter (mg/dL). The
guidelinesTrusted Source for healthy cholesterol levels are as follows:
- total cholesterol below 200 mg/dL
- LDL cholesterol less than 100 mg/dL
- HDL cholesterol above 40 mg/dL for men and above 50 mg/dL for women
Different regions and countries may have varying guidelines, so it is wise to speak to a doctor about the most accurate and up-to-date ranges.
Total cholesterol to HDL ratios
The total cholesterol to HDL cholesterol ratio is way to calculate cardiovascular risk. A high total cholesterol to HDL ratio indicates a higher risk for heart disease. It can be measured by dividing the total cholesterol by the HDL level.
A
desirable ratioTrusted Source is 5:1, and an optimal ratio is 3.5:1. The lower this number is, the healthier a person’s cholesterol levels are.
Total cholesterol does fluctuate, so more than one blood test might be required for an accurate assessment. Levels can change following a meal, so sometimes a blood test will be taken first thing in the morning before a person has breakfast.
Studies suggest that the total cholesterol to HDL ratio is a better marker of the risk of heart disease than LDL cholesterol levels alone.
Non-HDL cholesterol
Another method of assessing cholesterol levels is calculating a non-HDL cholesterol level. This is measured by subtracting HDL cholesterol from the total cholesterol.
This method is
considered to be more accurateTrusted Source by some doctors because it includes very low-density lipoprotein (VLDL) levels in the calculation.
Similarly to LDL cholesterol, VLDL cholesterol can also build up inside the walls of blood vessels, which is undesirable.
Ideally, a non-HDL cholesterol level should be
less than 130 mg/dL. A higher value than that increases the risk for heart disease.
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