6 doctors weighed in:

Whats best high density lipoprotein cholesterol range?

6 doctors weighed in
Dr. Irv Loh
Internal Medicine - Cardiology
2 doctors agree

In brief: Higher the better

Acceptable hdl-c traditionally has a lower level in men of 40 mg/dl and 50 mg/dl in women.
But generally, the higher the better. The problem is that our current therapies (lifestyle and drugs) have minimal to modest impact on raising hdl-c. Future agents may be more effective, but the proof of improved outcome will be needed. Plus, all hdl-c may not be alike, some more functional than others.

In brief: Higher the better

Acceptable hdl-c traditionally has a lower level in men of 40 mg/dl and 50 mg/dl in women.
But generally, the higher the better. The problem is that our current therapies (lifestyle and drugs) have minimal to modest impact on raising hdl-c. Future agents may be more effective, but the proof of improved outcome will be needed. Plus, all hdl-c may not be alike, some more functional than others.
Dr. Irv Loh
Dr. Irv Loh
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Dr. William Cromwell
Clinical Lipidology
1 doctor agrees

In brief: HDL-P trumps HDL-C

While higher hdl-c (> 40 in men, > 50 in women) is generally associated with lower cardiovascular disease (cvd) risk, it is the number of HDL particles (hdl-p) that is the best predictor of HDL risk (hdl-p > 40 umol/l less risk, hdl-p < 30 umol/l higher risk).
Because the amount of cholesterol in HDL is highly variable hdl-c and hdl-p may disagree. When they disagree risk tracks with hdl-p not hdl-c.

In brief: HDL-P trumps HDL-C

While higher hdl-c (> 40 in men, > 50 in women) is generally associated with lower cardiovascular disease (cvd) risk, it is the number of HDL particles (hdl-p) that is the best predictor of HDL risk (hdl-p > 40 umol/l less risk, hdl-p < 30 umol/l higher risk).
Because the amount of cholesterol in HDL is highly variable hdl-c and hdl-p may disagree. When they disagree risk tracks with hdl-p not hdl-c.
Dr. William Cromwell
Dr. William Cromwell
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Dr. Milton Alvis, jr
Preventive Medicine

In brief: Focus on Large-HDL-P

Ldl & HDL are lipoproteins, i.
e. Protein particles which carry all fats (including cholesterol) in the water outside cells. Ldl is always in nmol/l, best <700, HDL in µmol/l, best large-hdl >10. See NMR particle test, <$100. Hdl-c is an estimation of cholesterol within HDL particles, not the number or size of the particles, the far more important factor. Only large-hdl-p correlates with prevention.

In brief: Focus on Large-HDL-P

Ldl & HDL are lipoproteins, i.
e. Protein particles which carry all fats (including cholesterol) in the water outside cells. Ldl is always in nmol/l, best <700, HDL in µmol/l, best large-hdl >10. See NMR particle test, <$100. Hdl-c is an estimation of cholesterol within HDL particles, not the number or size of the particles, the far more important factor. Only large-hdl-p correlates with prevention.
Dr. Milton Alvis, jr
Dr. Milton Alvis, jr
Thank
1 comment
Dr. William Cromwell
Data regarding HDL-P subclass associations with outcomes can be complex and require analysis that address both suppressor variable effects between various subclasses, as well as multivariate adjustments for other confounders. Analysis of HDL-P in VA-HIT showed in properly adjusted analysis that small and medium HDL-P, but not large HDL-P, were significantly associated with outcomes. The most recent data sets to look at these issues are the Heart Protection Study and MESA. In both, total HDL-P was significantly, independently associated with outcomes. HDL subclasses did not add significantly to HDL-P in fully adjusted models. For these reasons total HDL-P, not large HDL-P, is the parameter that is most useful in CVD risk assessment.
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