At a glance

Also known as

HDL; HDL-C; 'good' cholesterol

Why get tested?

To assist in the determination of an overall risk profile for atherosclerotic diseases such as heart attack and stroke.

When to get tested?

Often performed as part of a general health check with cholesterol or a lipid profile. It may specifically  be ordered if you:

  • have a family history of cholesterol disorders
  • have a family history of heart attacks, especially at a young age
  • are overweight
  • have diabetes
  • have thick yellow patches (xanthomas) around your eyes or elsewhere on your skin
  • have high blood pressure
  • have had acute inflammation of the pancreas (acute pancreatitis)
  • are a smoker.
Sample required?

A blood sample drawn from a vein in the arm or from a finger-prick

Test preparation needed?

Whilst HDL blood tests can be performed accurately on non-fasting specimens, the  test is usually performed as part of a complete lipid profile. In these circumstances, fasting for about 12 hours is required, with only water permitted.

What is being tested?

The HDL cholesterol test measures the amount of cholesterol carried by HDL (high density lipoprotein) particles in the blood. Too much cholesterol in the bloodstream can be damaging if it is deposited in the walls of the blood vessels. However, HDL particles actually remove excess cholesterol from the body. Hence, having a high level of cholesterol carried by HDL particles is generally good and HDL cholesterol is often termed ‘good’ cholesterol. 

How is the sample collected for testing?

The test for HDL cholesterol uses a blood sample. Most often the blood sample is collected from a vein. Sometimes HDL cholesterol is measured using a drop of blood collected by puncturing the skin on a finger. A finger-prick sample is typically used when HDL cholesterol is being measured on a portable testing device.

Is any test preparation needed to ensure the quality of the sample?

If this test is being performed as part of a complete lipid profile then fasting for about 12 hours is usually required, Only water is permitted.

The Test

How is it used?

The test of HDL cholesterol is used to determine your risk of heart disease. If high cholesterol is due to high HDL cholesterol, a person is at lower risk and treatment for high cholesterol may not be advised. HDL cholesterol results are rarely considered in isolation and form part of an overall picture of cardiac risk.

When is it requested?

HDL cholesterol is usually requested with other tests; either with cholesterol or as part of a lipid profile, including LDL cholesterol and triglycerides. The combination of total cholesterol and HDL cholesterol is very useful for screening for the risk of heart disease since it is not necessary to fast for these two tests. In contrast, a more complete lipid profile requires fasting for about 12 hours.

What does the test result mean?

High HDL cholesterol is better than low HDL cholesterol. A healthy HDL cholesterol level is over 1 mmol/L.

However, your HDL cholesterol should be interpreted in the context of the overall findings from the lipid profile and in consultation with your doctor about other risk factors for heart disease.

About Reference Intervals

Is there anything else I should know?

HDL cholesterol should not be measured when a person is unwell. Cholesterol is temporarily low during acute illness, immediately following a heart attack, or during stress (like from surgery or an accident). You should wait about 6 weeks after any illness to have cholesterol measured.

In women, HDL cholesterol may change during pregnancy. You should wait about six weeks after your baby is born to have your HDL cholesterol measured.

Common Questions

What treatments are recommended for low HDL cholesterol levels?

If you have low HDL cholesterol you may be able to increase it by making some changes in your lifestyle. If you are a smoker, stopping smoking may increase your HDL cholesterol. Exercising more and, if you are overweight, losing weight may also help. A diet with a moderate intake of carbohydrates and fat helps maintain healthy HDL cholesterol levels. The type of fat you eat is also important, particularly avoiding `trans' fatty acids, such as the modified vegetable fats that may be present in deep fried `fast-foods'. Moderate alcohol consumption may increase HDL cholesterol. Taking fish oil supplements and Vitamin B3 supplements may also increase HDL cholesterol and your doctor may prescribe medication to help.

My HDL cholesterol is high. Is this a problem?

No. High HDL cholesterol is generally good.

Last Review Date: August 1, 2018