HDL — Normal Range & Interpretation

Clinical Context

HDL cholesterol measures the high-density lipoprotein fraction that transports cholesterol from peripheral tissues back to the liver for excretion. This reverse cholesterol transport makes HDL cardioprotective, and clinicians use it alongside LDL, triglycerides, and total cholesterol to stratify atherosclerotic cardiovascular disease risk. Levels at or above 60 mg/dL count as a negative risk factor in ASCVD calculations.

Aerobic exercise, moderate alcohol intake, weight loss, smoking cessation, and estrogen raise HDL, which explains why premenopausal women typically run higher levels than men. Low HDL accompanies metabolic syndrome, type 2 diabetes, obesity, sedentary lifestyle, cigarette smoking, anabolic steroid use, and genetic disorders such as Tangier disease. NPs address low HDL primarily through lifestyle modification, since pharmacologic agents like niacin and fibrates show limited outcome benefit when LDL is already controlled on a statin.

High-yield for NP boards: sex-specific cutoffs, recognition that HDL below 40 in men and below 50 in women signals increased cardiovascular risk, and the role of HDL at or above 60 as protective. Expect questions linking low HDL to metabolic syndrome criteria, identifying exercise as the first-line intervention, and interpreting a full lipid panel to guide statin therapy decisions in primary care.

Related Labs

• Total Cholesterol — mg/dL
• LDL — mg/dL
• Triglycerides — mg/dL

Sources

• MedlinePlus