A good HDL cholesterol level is 60 mg/dL or higher for both men and women. Below 40 mg/dL in men or below 50 mg/dL in women is considered “at risk,” meaning your body may not be clearing excess cholesterol from your bloodstream efficiently enough to protect against heart disease.
What HDL Actually Does
HDL stands for high-density lipoprotein, and it earns its “good cholesterol” nickname through a process called reverse cholesterol transport. HDL particles move through your bloodstream picking up excess cholesterol from your tissues and artery walls, then carry it back to your liver. Your liver either recycles that cholesterol for other uses or sends it to the gallbladder to be removed from the body. This cleanup process is one of the main ways your cardiovascular system protects itself from plaque buildup.
HDL Targets by Age and Sex
The numbers differ slightly depending on who you are. For adult men, anything below 40 mg/dL puts you at increased cardiovascular risk. For adult women, that threshold is higher, at 50 mg/dL. Both men and women should aim for 60 mg/dL or above, which is considered desirable.
Children and teens have slightly different cutoffs. In childhood, an HDL level above 45 mg/dL is considered acceptable, 40 to 45 is borderline, and anything below 40 is flagged as abnormal. The American Heart Association recommends a first cholesterol screening between ages 9 and 11, with a follow-up between 17 and 21. After that, most adults get tested every four to six years unless they have risk factors like high blood pressure, diabetes, or a family history of heart disease.
When HDL Is Too High
More isn’t always better. Research published in the AHA journal Hypertension found a U-shaped relationship between HDL levels and cardiovascular outcomes, meaning risk goes up at both ends. The protective effect of HDL appears to plateau and then reverse once levels climb above roughly 80 mg/dL. In male patients with high blood pressure, HDL above 80 mg/dL was associated with increased cardiovascular risk rather than decreased risk.
This doesn’t mean you should worry if your HDL is in the 60s or 70s. The sweet spot for most people falls in the 40 to 80 mg/dL range, with 60 and above being the general target. Extremely high HDL, often driven by genetics or certain medications, is worth discussing with your doctor rather than celebrating.
Your Cholesterol Ratio Matters Too
HDL doesn’t exist in isolation. One useful way to gauge your overall risk is the cholesterol ratio: your total cholesterol divided by your HDL. If your total cholesterol is 200 mg/dL and your HDL is 50, your ratio is 4 to 1. A lower ratio signals better cardiovascular health. Many clinicians now prefer looking at non-HDL cholesterol (your total cholesterol minus your HDL) as an even more useful predictor, since it captures all the cholesterol particles that contribute to plaque buildup in a single number.
How to Raise Low HDL
Diet
The most effective dietary shift is replacing bad fats with good ones. That means cutting back on saturated fats found in full-fat dairy, processed meats like sausage and bacon, and foods made with butter or lard. Trans fats, which show up in some margarines, fried foods, and packaged baked goods, are even worse for your HDL. Replace those with unsaturated fats from avocados, olive oil, and nuts. Limiting refined carbohydrates and added sugar also helps, as does eating more fiber-rich foods like oatmeal and beans.
Exercise
Regular aerobic exercise raises HDL, but the effect is more modest than many people expect. A meta-analysis of 66 exercise training studies found an average increase of about 1.2 mg/dL. People who start with normal HDL levels tend to see a larger bump, around 5 mg/dL on average. Those who begin with low HDL see smaller absolute increases, closer to 2 mg/dL, though the percentage gain can still be meaningful. Exercise also improves HDL function, making the particles better at clearing cholesterol even if the number on your lab report doesn’t jump dramatically.
Other Lifestyle Factors
Smoking suppresses HDL, and quitting typically leads to a noticeable increase within weeks. Carrying excess weight, particularly around the abdomen, is one of the strongest predictors of low HDL. Even modest weight loss of 5 to 10 percent of body weight can improve your levels. Alcohol in small amounts has been linked to slightly higher HDL, but the cardiovascular risks of drinking generally outweigh this benefit, and no medical guidelines recommend starting to drink for the sake of your cholesterol.
How HDL Testing Works
HDL is measured as part of a standard lipid panel, which is a simple blood draw. You’ll typically be asked to fast for 9 to 12 hours beforehand, though some newer tests don’t require fasting. Your results will show HDL alongside your total cholesterol, LDL, and triglycerides. If your initial results come back abnormal, or if you’re already on cholesterol-lowering medication, you’ll likely be tested more frequently than the standard every four to six years.
One thing to keep in mind: HDL can fluctuate by 10 to 15 percent from one test to the next based on hydration, recent meals, illness, or even the time of year. A single reading that looks slightly off isn’t necessarily cause for concern. Trends over multiple tests give a much clearer picture of where you actually stand.