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LDL vs HDL Cholesterol: What’s the Difference?

This article has been medically reviewed by:
Bernard Gros, M.D., F.A.C.C.
Bernard Gros, M.D., F.A.C.C.

We’re all familiar with the term cholesterol but most of us don’t start reading much about it until it becomes a personal matter that needs attention. For most, understanding the ins and outs of “bad” and “good” cholesterol can be overwhelming but it’s essential when prioritizing your heart health. By educating yourself on the different types of cholesterol and realizing what it does in the body, you’ll start to feel more confident and prepared on managing your cholesterol levels. 

What is Cholesterol?

You may have heard about cholesterol at your latest doctor’s visit. This fat-like substance exists in every cell of the body and aids in the production of hormones, vitamin D and even digestion. Even though your body makes all of the cholesterol it needs, you can also get cholesterol from eating certain foods. Cholesterol is found in fatty foods like meat, eggs and cheese. 

When there is too much cholesterol in the blood it can form plaque that sticks to the walls of the arteries. Having plaque buildup in the walls of the arteries is problematic for a number of reasons. First of all, it causes the blood vessels to become more narrow which impacts your overall heart health, affecting blood pressure, blood flow and oxygenation. In addition to this, the plaque that has built up in the blood vessels can become dislodged and lead to a clot that may cause a heart attack or stroke. 

High cholesterol levels can affect the overall health of your heart because the heart has to work harder to pump blood through the narrowed arteries. It is important to stay on top of your cholesterol levels by having them checked regularly to keep your heart healthy. When cholesterol levels get out of hand, it can lead to cardiovascular diseases such as high blood pressure, coronary artery disease and peripheral artery disease. 

There are two types of cholesterol: LDL and HDL. LDL cholesterol is considered the “bad” cholesterol, because it aids in the transport of cholesterol to the arteries. HDL cholesterol is considered “good” cholesterol because it facilitates the release of cholesterol from the body by helping it reach the liver. 

Good Vs. Bad Cholesterol

HDL and LDL stand for high density lipoprotein and low density lipoprotein. A lipoprotein is made up of a lipid (or fat) and a protein. These molecules combine so that they can transport throughout the body. 

HDL cholesterol is the “good” cholesterol because it transports to the liver where it is excreted from the body. LDL cholesterol is the “bad” cholesterol because it transports all over the body and eventually to the blood vessels where it can accumulate. When cholesterol accumulates in the blood vessels, it causes the vessels to narrow which can lead to cardiovascular issues like high blood pressure. 

Cholesterol levels are affected by a number of factors, some controllable and others that are not. Some people are born with high cholesterol and have levels that stay high regardless of their lifestyle. However, lifestyle factors do have a serious effect on cholesterol levels. Diet plays a major role because certain foods cause an increase in cholesterol levels. Foods to avoid if you’re hoping to lower your cholesterol include:

  • High fat, processed meats like deli meats and pepperoni
  • Greasy take out food like pizza and hamburgers
  • Buttery foods and fried foods

Exercising regularly can also help to keep cholesterol levels low since it encourages cardiovascular health. Cardio workouts like walking, running and cycling are great for keeping cholesterol levels at bay. Other lifestyle factors that may cause increased cholesterol include smoking and poorly managed stress. 

When cholesterol levels get too high, it can lead to complications like chest pain, heart attack and stroke. Atherosclerosis occurs when cholesterol and other substances build up along the walls of the arteries. This is a dangerous condition because it can lead to a reduction of blood flow to the heart. This is due to those surrounding arteries potentially being clogged or carrying plaque. Also, if the plaque becomes dislodged, it can cause a blood clot in the heart or brain which can result in a heart attack or stroke.

When referring to dangerously high cholesterol levels, we are only talking about LDL cholesterol (or the “bad” cholesterol) since this is the type of cholesterol that builds up in the body. On the other hand, HDL cholesterol helps to transport excess cholesterol out of the body to counter this build up. So, if your HDL cholesterol levels are high, this is actually a good thing! 

How to Measure Cholesterol Levels

Measuring cholesterol levels will likely become a part of your routine health care as you age. Cholesterol levels are a part of a blood test called a lipid panel. This blood test looks at LDL cholesterol, HDL cholesterol, total cholesterol and triglyceride levels. 

Lipid panels are performed by taking a blood sample and sending it to a lab for testing. Your doctor will most likely ask Pyou fast for 10-12 hours before your lipid panel, meaning you’ll want to schedule it in the morning and avoid eating before arriving for the test. 

Measurement guidelines for cholesterol levels are as follows (U.S. Guidelines):

  • Total cholesterol: Below 200 mg/dL = desirable; 200-239 mg/dL = borderline high; 240 mg/dL and up = high
  • LDL cholesterol: LDL readings range anywhere from “optimal,”“near optimal,” “borderline high,” “high” and “very high”. Optimal LDL levels vary depending on your health history and age. Generally, you’ll want your LDL levels to fall below 70 mg/dL if you have a history of heart disease. Anywhere from 100-129 mg/dL is considered “near optimal” for anyone who does not suffer from heart disease. Here is a full breakdown of the recommended LDL levels. 
  • HDL cholesterol: Recommended HDL levels are different for men and women. For both men and women, 60 mg/dL and up is best. For women, 50-59 mg/dL is okay and below 50 mg/dL is considered poor. For men, 40-59 mg/dL is considered okay and below 40 mg/dL is considered poor. 

With 38% of Americans diagnosed, high cholesterol is a common condition in today’s society. 

How often should I get a cholesterol test?

Your age, risk factors and family history will help determine how often you should be getting your cholesterol tested. Generally, the first test should be taken around ages nine to 11 and then every five years after that. If you have risk factors such as a family history of high cholesterol or active heart disease, then you’ll likely need to have your cholesterol tested more frequently. 

At UCF Health, we can help show you how to prevent heart disease by monitoring your cholesterol levels to keep your heart strong and healthy. Talk with your doctor about how often you should be having your lipids checked.

How to Regulate Cholesterol Levels

Keeping your cholesterol levels stable is important for anyone (even if you don’t think you’re at risk of having high cholesterol). Try some of the following steps to help keep your cholesterol levels at bay:

  • Exercise regularly
  • Incorporate heart healthy snacks into your diet, such as nuts and fruit
  • Avoid smoking
  • Manage stress in a healthy way

Working closely with your cardiologist can not only teach you how to keep your cholesterol levels where they should be, but it can also help you learn how to strengthen your heart so you can function at your full capacity and live a healthy and balanced life. 

UCF Health’s cardiology team can help you live a long and healthy life by guiding you on how to keep your cholesterol levels low to support optimal heart health. Early diagnosis and treatment is an important step in prioritizing and ensuring a healthy heart. Start taking action by visiting your cardiologist in Orlando. Use our online scheduling tool to schedule your next visit with UCF Health today. 

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