Question 1

What do the 2026 AHA/ACC guidelines say about HDL?

Accepted Answer

HDL is one of the lipid inputs in the new PREVENT risk equations, so it still matters for risk estimation. But it is not a treatment target on its own. Trials of HDL-raising drugs have failed to reduce cardiovascular events, so the guidelines treat HDL as a useful risk marker rather than something to push up directly.

Question 2

What foods raise HDL cholesterol?

Accepted Answer

Olive oil, fatty fish (salmon, mackerel, sardines), nuts, avocados, and moderate amounts of dark chocolate or red wine all nudge HDL up. The effect from food alone is modest, usually a few mg/dL. Exercise, weight loss, and quitting smoking move HDL more than diet does.

Question 3

How can I raise my HDL?

Accepted Answer

Regular aerobic exercise is the most effective way to raise HDL, typically increasing it by 5-10%. Quitting smoking, losing excess weight, and replacing refined carbs with healthy fats (olive oil, nuts, avocados, fatty fish) also help. Getting adequate sleep and reducing chronic stress contribute to better HDL levels. Genetic factors play a significant role, so some people have chronically low HDL despite a healthy lifestyle. Medications specifically targeting HDL have been disappointing, so the best approach is lifestyle-focused.

Question 4

What is a healthy HDL level?

Accepted Answer

HDL above 40 mg/dL is considered the minimum acceptable level for men, and above 50 mg/dL for women. Levels of 60 mg/dL and above are considered protective against heart disease. Unlike most lipid markers, higher is generally better for HDL, though very high levels (above 100 mg/dL) may not provide additional benefit and in rare cases may reflect dysfunctional HDL particles.

Question 5

What units is HDL reported in?

Accepted Answer

US labs report HDL in mg/dL. Most countries outside the US use mmol/L. To convert, divide mg/dL by 38.67. So an HDL of 60 mg/dL is roughly 1.55 mmol/L.

Question 6

What does an HDL of 38 or 39 mean?

Accepted Answer

Below 40 mg/dL (men) or 50 mg/dL (women) is considered low and is associated with higher cardiovascular risk. An HDL of 38-39 falls just under the cutoff. The fix is usually exercise, weight loss, and stopping smoking. HDL above 60 has historically been called protective, though very high HDL (above 90) has been linked to higher risk in some studies, so higher is not always better.

Question 7

What is HDL cholesterol?

Accepted Answer

HDL (high-density lipoprotein) is often called “good” cholesterol because it acts as your body’s cholesterol recycling system. HDL particles scavenge excess cholesterol from artery walls and carry it back to the liver for disposal, a process called reverse cholesterol transport. Higher HDL is generally protective against heart disease. However, very high levels (above 100 mg/dL) may paradoxically increase risk in some people, and drugs that artificially raise HDL have not consistently reduced heart attacks, suggesting HDL function matters more than the number alone.

HDL Cholesterol

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What is a normal HDL cholesterol by age?

Biomarkers related to HDL

Frequently asked questions about HDL

HDL test cost

Where to test HDL

Know your HDL. Know your health.