HDL test

A blood sample is needed. Most of the time, blood is drawn from a vein located on the inside of the elbow or the back of the hand.

You should not eat for 9 to 12 hours before the test.

Alcohol and some medicines can interfere with blood test results.

• Make sure your health care provider knows what medicines you take, including over-the-counter medicines and supplements.
• Your provider will tell you if you need to stop taking any medicines before you have this test.
• Do not stop or change your medicines without talking to your provider first.

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

HDL cholesterol is usually measured together with other blood fats. Often it is done to help determine your risk of developing heart disease.

High HDL helps lower your risk for:

• Heart disease
• Heart attack
• Stroke

You want your HDL cholesterol to be high (unless it is due to a condition described below). Optimal values are 60 mg/dL or 1.55 millimoles per liter (mmol/L) or above.

At risk:

• Men - Less than 40 mg/dL (1.04 mmol/L)
• Women - Less than 50 mg/dL (1.29 mmol/L)

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

Low HDL cholesterol levels may be due to:

• Eating a diet high in saturated fats or a diet high in carbohydrates and low in fat
• Lack of physical activity
• Being overweight or having obesity
• Metabolic syndrome
• Diabetes
• A disorder passed down through families in which there are high amounts of cholesterol and triglycerides in the blood (familial combined hyperlipidemia)
• Side effect of certain medicines

Overall, the treatment of low HDL focuses on increased exercise and changes in the diet.

An elevated HDL is anything over 80 mg/dL (2.0 mmol/L). This can be a result of:

• A genetic variation that causes the body to produce too much HDL 
• Overactive thyroid (hyperthyroidism)
• Drinking too much alcohol

There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

• Fainting or feeling lightheaded
• Multiple punctures to locate veins
• Hematoma (blood buildup under the skin)
• Excessive bleeding
• Infection (a slight risk any time the skin is broken)

Certain medicines, pregnancy, infection, and some medical conditions can affect test results.

HDL cholesterol; High-density lipoprotein (HDL) cholesterol levels

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Genest J, Mora S, Libby P. Lipoprotein disorders and cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 27.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1046-e1081. PMID: 30565953 pubmed.ncbi.nlm.nih.gov/30565953/.

Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

Robinson JG. Disorders of lipid metabolism. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 190.

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.