Good vs Bad Cholesterol: HDL, LDL and Your Numbers

The short answer: HDL is called good cholesterol because it carries extra cholesterol back to your liver to be removed. LDL is called bad cholesterol because too much of it builds plaque in your arteries. For most adults, healthy means LDL under 100 mg/dL (2.6 mmol/L) and HDL of 60 mg/dL (1.6 mmol/L) or more. An LDL of 190 mg/dL (4.9 mmol/L) or above is very high.

Cholesterol itself is a waxy substance your body needs to work properly, MedlinePlus explains. Your liver makes it, and some comes from food. The trouble starts when too much sits in your blood.

Why is HDL good and LDL bad?

HDL is good because it carries cholesterol away from your arteries, and LDL is bad because it delivers cholesterol that can stick in them. Both are lipoproteins, small particles of fat and protein that move cholesterol through your blood, NHLBI says.

LDL, low-density lipoprotein, is the main source of cholesterol buildup and blockages in the arteries, according to NHLBI. Extra LDL joins other substances to form plaque, which narrows arteries. When that happens in the heart’s arteries, MedlinePlus says, it can cause chest pain or a heart attack.

HDL, high-density lipoprotein, picks up extra cholesterol and takes it to your liver, which breaks it down and sends it out of your body. Cleveland Clinic adds that HDL helps calm inflammation and plays a role in preventing blood clots.

Your test may show two more numbers. Non-HDL cholesterol is your total cholesterol minus HDL, so it counts LDL plus the other harmful types. Triglycerides are a separate fat made from extra calories, and MedlinePlus says high levels raise your risk of heart disease too.

What are good and bad cholesterol levels?

Good cholesterol levels for most adults are LDL under 100 mg/dL, non-HDL under 130 mg/dL, HDL of 60 mg/dL or more and triglycerides under 150 mg/dL. Here they are in both mg/dL, used in the US, and mmol/L:

Measure	Healthy	Borderline	High or risky
LDL ("bad")	Under 100 mg/dL (2.6 mmol/L)	100 to 129 is near optimal (2.6 to 3.3); 130 to 159 is borderline high (3.4 to 4.1)	160 to 189 is high (4.1 to 4.9); 190 or more is very high (4.9+)
HDL ("good")	Above 40 mg/dL (1.0 mmol/L) for men or 50 (1.3) for women; 60 (1.6) or more is best		Low: under 40 mg/dL (1.0) for men, under 50 (1.3) for women
Non-HDL	Under 130 mg/dL (3.4 mmol/L)		130 or more
Triglycerides	Under 150 mg/dL (1.7 mmol/L)	150 to 199 mg/dL (1.7 to 2.2)	200 to 499 is high (2.3 to 5.6); 500 or more is very high
Total cholesterol	Under 200 mg/dL (5.2 mmol/L)
Lp(a)	Below 30 mg/dL (75 nmol/L)	30 to 50 mg/dL (75 to 125 nmol/L), a gray zone	50 mg/dL (125 nmol/L) or more

Sources: MedlinePlus, NHLBI, the 2018 AHA/ACC cholesterol guideline and the Cleveland Clinic Journal of Medicine. We converted mg/dL to mmol/L and rounded. The NHS uses its own simple targets in mmol/L: total cholesterol below 5, non-HDL below 4, and HDL above 1.0 for men or 1.2 for women.

Your own targets may be lower if you have heart disease or diabetes. MedlinePlus lists an LDL of 70 mg/dL or below for many people at high risk.

What cholesterol level is dangerous?

An LDL of 190 mg/dL (4.9 mmol/L) or higher is the clearest danger sign. MedlinePlus calls it very high, and the 2018 AHA/ACC guideline treats it as severe hypercholesterolemia, a level where doctors usually discuss treatment without first calculating your risk score.

Other numbers that worry doctors:

Triglycerides of 500 mg/dL (5.6 mmol/L) or more, which MedlinePlus calls very high.
Triglycerides that stay at 175 mg/dL (2.0 mmol/L) or more, which the AHA/ACC guideline lists as a factor that raises heart risk.
An Lp(a) of 50 mg/dL (125 nmol/L) or more, another risk-raising factor in the same guideline.
A low HDL together with a high LDL.

High cholesterol doesn’t usually cause symptoms, the NHS says, so a blood test is the only way to know. High cholesterol that starts at a young age can be inherited, a condition called familial hypercholesterolemia, which the NHS and NHLBI both describe. If close relatives had early heart attacks, tell your doctor.

What cholesterol number is most important?

LDL is usually the most important cholesterol number, because it’s the main driver of plaque in your arteries. NHLBI’s goal for a healthy profile adds two more: non-HDL below 130 mg/dL, with HDL of at least 40 mg/dL for men and 50 mg/dL for women. Non-HDL captures LDL plus other harmful particles, so MedlinePlus says it gives a better picture of all the bad types.

A high HDL doesn’t cancel out a high LDL. NHLBI notes that higher HDL may be less protective than once believed, and that high blood pressure or diabetes may outweigh its benefits. Cleveland Clinic adds that HDL above 80 mg/dL can point to an underlying problem.

Doctors weigh these numbers with your blood pressure, age and health to estimate your overall risk. Our guide to how to lower blood pressure covers the other big number in that sum.

What is a high lipoprotein(a) level?

A high lipoprotein(a), or Lp(a), level is 50 mg/dL (125 nmol/L) or above, the cutoff used by the AHA/ACC and the National Lipid Association. Lp(a) is a lipoprotein whose level is set by your genes. NHLBI says it’s unlikely to change much from childhood to old age and can raise your heart risk even when your other numbers look healthy.

Between 20% and 25% of people worldwide have elevated Lp(a), a 2025 review in the Cleveland Clinic Journal of Medicine says, and it’s largely unaffected by lifestyle changes. It isn’t part of a routine lipid panel. NHLBI says your doctor may order it if you have a family history of stroke or early heart disease, or don’t know your family history. European, Canadian and National Lipid Association guidelines suggest testing every adult at least once.

How do you raise HDL and lower LDL?

You raise HDL and lower LDL mostly with the same habits: swapping saturated fat for unsaturated fat, moving more and not smoking. Here’s what sources report moves each number:

Number	What pushes it the wrong way	What helps
LDL	Saturated and trans fat, inactivity, smoking, genes, menopause, kidney disease, diabetes, underactive thyroid, some medicines	Heart-healthy eating low in saturated and trans fat, such as the DASH or TLC plans; regular activity; medicine if needed
HDL	Smoking and secondhand smoke, inactivity, insulin resistance and diabetes, some medicines such as beta blockers and progestins	Unsaturated fats from olive oil, nuts and avocado in place of saturated fat; less sugar; 30 minutes of moderate to vigorous exercise on most days; not smoking
Triglycerides	Regularly eating more calories than you burn, especially sugar; too much alcohol; smoking; poorly controlled type 2 diabetes; thyroid, liver or kidney disease	Regular activity, limiting sugar and refined foods, limiting alcohol, not smoking, swapping saturated fat for healthier fats
Lp(a)	Your genes	Largely unaffected by lifestyle; your doctor focuses on your other risks

Sources: NHLBI, MedlinePlus and the Cleveland Clinic Journal of Medicine. The NHS suggests at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week, and no more than 14 units of alcohol a week. If a medicine might be affecting your numbers, talk to your doctor before changing anything.

For the specific foods with the best evidence, such as oats, beans, nuts and soy, read foods that lower cholesterol. See also the healthiest cooking oil and how much alcohol is safe. Blood sugar and blood fats are closely linked, so if your sugar is also creeping up, see our prediabetes diet guide.

How often should cholesterol be checked?

Most adults should have their cholesterol checked every 5 years, with more frequent tests later in life. NHLBI and MedlinePlus give this general guide:

Children: first test at ages 9 to 11, then every 5 years. Some start at age 2 if there’s a family history of high cholesterol, heart attack or stroke.
Younger adults: every 5 years.
Men 45 to 65 and women 55 to 65: every 1 to 2 years.
Over 65: every year.

You may need tests more often if you have heart disease, diabetes or a family history of high cholesterol. As for fasting, advice differs: NHLBI says your provider may ask you to fast for 8 to 12 hours, while the NHS says eating beforehand doesn’t make much difference. Follow the instructions you’re given.

Your next step

Find your last test result and check two numbers first: LDL and non-HDL. If it’s been more than 5 years, or you’ve never had Lp(a) checked and heart disease runs in your family, ask your doctor at your next visit. Then pick one swap from the table above for this week. If you’d like an easy start in the kitchen, The Banana Book below has simple recipes with the fiber listed on each one.

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Quick questions

Is HDL the good cholesterol?

Yes. HDL, high-density lipoprotein, is the good cholesterol because it carries extra cholesterol from your body back to your liver, which removes it. MedlinePlus says higher HDL numbers are better. A healthy level is above 40 mg/dL for men and above 50 mg/dL for women, and 60 mg/dL or more is best.

Can HDL cholesterol be too high?

It can. Cleveland Clinic calls HDL above 80 mg/dL high and says abnormally high levels may point to an underlying problem with how your body balances cholesterol. Causes it lists include alcohol use disorder, an overactive thyroid, gene changes and medicine side effects. Your doctor can look for the cause.

What is a dangerous LDL level?

An LDL of 190 mg/dL (4.9 mmol/L) or higher is very high, MedlinePlus says. The 2018 AHA/ACC guideline treats it as severe hypercholesterolemia, which doctors usually treat without first calculating a risk score. LDL of 160 to 189 mg/dL is high and counts as a factor that raises heart risk.

Do you need to fast for a cholesterol test?

Not always. The NHS says eating before the test doesn’t make much difference to your levels, and the AHA/ACC guideline allows fasting or nonfasting tests for screening. NHLBI says your provider may still ask you to fast for 8 to 12 hours, so follow the instructions you’re given.

Does cholesterol go up with age?

Usually, yes. NHLBI says that as you get older, your liver doesn’t remove LDL cholesterol as well as it did when you were young. After menopause, women’s total and LDL cholesterol usually rise while HDL falls. High cholesterol is most often diagnosed between ages 40 and 59, NHLBI says.

Is high cholesterol genetic?

It can be. NHLBI says family members usually have similar cholesterol levels, and inherited gene changes can cause familial hypercholesterolemia, which makes LDL harder for your body to clear. Lp(a) is also set by your genes. Heart-healthy habits still help, even with a family history.

This article is general information, not medical advice. Healthy cholesterol targets depend on your own health and risk, so ask your doctor what your numbers mean for you. Don’t start, stop or change any medicine without talking to your doctor. Call 911 or your local emergency number for chest pain.

Good vs bad cholesterol: what HDL, LDL and your other numbers really mean