Is low hdl as much a cardiovascular risk as high ldl? does hdl numbers really matter if ldl is under control? lots of conflicting info out there.

Generally, yes: At any given level of total and LDL cholesterol, the higher the HDL the lower the cardiac risk and vice-versa. The reason doctors tend to focus on lowering LDL is that there are to date no proven results from raising HDL with drugs, the one exception being niacin, notoriously hard to take in meaningful amounts. Low HDL may be a marker of risk rather than a target for treatment.

Agreed: Yes, lots of conflicting material. Right now, it seems that high ldl, especially LDL particle number is high can be a culprit - get a more sophisticated blood test than a "calculated ldl." you can have a normal LDL at 99, but the particle number may be 1800 which is high. Hdl should be over 40, but many people genetically have them in the 20's.

Yes, though Debated: Dr. Cromwell's answer is the most informed & accurate. The correct issues, from basic & science clinical research for >60 years has always been the fat carrying particles (not one particular fat they carry, such a cholesterol) & traffic patterns of where the fat going vs. Being removed. Cells, if overloaded with intracellular fat become sick & die. Ldl-p deliver, large hdl-p remove fat molecules.

Bottom line is: You want your HDL as high as possible and LDL as low as possible. In women, low HDL is an independent risk factor for premature heart disease regardless of ldl. So both are important.

More of a riks: For populations of patients the risk of heart disease and atherosclerosis increases by 2-3% for 1% drop in hdl, but only 1/1 with LDL raising. Thus the same drop in HDL is associated with a greater increase in risk than the same increase in ldl. For individuals, however, yes more complicated - levels of HDL may not tell us what is happening with a particular patient. Hdl function may be the key.