HDL cholesterol or “good cholesterol” represents the level of blood cholesterol that circulates as a high-density particle (lipoprotein). This particle contains a protein (apolipoprotein A) that directs HDL cholesterol to the liver, where the cholesterol will be converted into bile salt and then eliminated in the intestine. HDL cholesterol is the only form of cholesterol that the body can eliminate. The higher the level of HDL cholesterol, the greater its protective effect.
The HDL cholesterol level must be interpreted along with the lipid profile (LDL cholesterol, non-HDL cholesterol, apolipoprotein B) while taking into account the risk of developing CVD within the 10 years following the sample (Framingham risk), which is a calculation that includes age, sex, smoking, treated or untreated hypertension and the presence of diabetes in addition to HDL cholesterol levels and total cholesterol levels. The higher the Framingham risk, the higher the desirable HDL cholesterol level should be.
HDL cholesterol level decreases temporarily during acute illnesses, immediately following a heart attack or during stress (such as surgery or an accident). You must wait at least 6 weeks after an illness before measuring your cholesterol.