How Do Cholesterol Levels Affect Heart Health?

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My doctor says my LDL and triglycerides are high, but my HDL is fine. Do I still need to worry about my heart?

People with appropriately high HDL cholesterol levels often have low LDL and triglycerides as well, so it’s been difficult to determine how big a role HDL plays on its own. But a recent analysis found that having high HDL does not override the increased risk of heart attack and stroke in people with elevated LDL and triglycerides.

The analysis, published in a 2016 issue of Circulation: Cardiovascular Quality and Outcomes, examined data on more than 3,000 patients whose hearts were healthy at the beginning of the study.

It found that people with low HDL—a known risk factor for cardiovascular disease—had a further increase in their risk of heart attack and stroke over the next two decades if they also had elevated LDL and triglycerides. On the other hand, high HDL stopped being a positive sign if people’s LDL and triglycerides were too high.

It’s important to look at all your blood lipids, not just HDL. A beneficial HDL level is 40 mg/dL or higher in men and 50 mg/dL or higher in women, and LDL and triglycerides should be kept below 100 mg/dL.