Can HDL be too high?

High-density lipoprotein (HDL) cholesterol is often referred to as the “good” cholesterol because it helps remove other, more harmful forms of cholesterol from your blood. It’s usually thought that the higher your HDL levels are, the better. In most people, this is true. But some research shows that high HDL can actually be harmful in certain people.

Typically, doctors recommend an HDL level of 60 milligrams per deciliter (mg/dL) of blood or higher. HDL that falls within the range of 40 to 59 mg/dL is normal, but could be higher. Having HDL under 40 mg/dL increases your risk of developing heart disease.

Research published by the journal 动脉硬化，血栓形成和血管生物学 found that people with high levels of C-reactive proteins after having had a heart attack may process high HDL negatively. C-reactive proteins are produced by your liver in response to high levels of inflammation in your body. Instead of acting as a protective factor in heart health, high HDL levels in these people could instead increase the risk of heart disease.

尽管您的水平可能仍处于正常范围内，但如果您患有这种炎症，您的身体可能会以不同的方式处理HDL。这项研究研究了来自最近患有心脏病发作的767名非糖尿病患者的血液。他们使用数据来预测研究参与者的结果，发现那些HDL和C反应蛋白水平高的人是心脏病特别高风险的组。

Ultimately, more research needs to be done to determine the risks of high HDL in this particular group of people.

Other conditions and medications associated with high HDL

High HDL is also linked to other conditions, including:

  • thyroid disorders
  • 炎症性疾病
  • alcohol consumption

Sometimes cholesterol-controlling medications can also raise HDL levels. These are usually taken to lower LDL, triglyceride, and total cholesterol levels. Medication types that have been linked to increased HDL levels include:

  • bile acid sequestrants, which decrease fat absorption from the foods you eat
  • 胆固醇吸收抑制剂
  • omega-3脂肪酸补充剂，降低血液中的甘油三酸酯，但也会增加HDL胆固醇
  • 他汀类药物，阻止肝脏产生更多胆固醇

HDL水平的提高通常是HDL水平较低的人的积极副作用，因为在大多数情况下，它会降低患心血管疾病的风险。

血液测试可以确定你的高密度脂蛋白水平。在添加ition to an HDL test, your doctor will also look for LDL and triglyceride levels as a part of an overalllipid profile。您的总级别也将被衡量。结果通常只需几天才能处理。

某些因素会影响您的测试结果。如果：

  • you’ve recently been ill
  • 你怀孕了
  • you’ve given birth in the last six weeks
  • you hadn’t been fasting before the test
  • you’re more stressed than usual
  • 您最近心脏病发作

All these factors can lead to inaccurate measurements of HDL in the blood. You may need to wait several weeks before taking a cholesterol test to make sure the results are correct.

In most people, high HDL is not harmful, so it doesn’t necessarily require treatment. The action plan depends largely on how high your levels are, as well as your overall medical history. Your doctor can help determine whether you need to actively lower HDL levels or not.

您的总体胆固醇水平可能会降低：

  • 不吸烟
  • drinking alcohol in moderate amounts only (or not at all)
  • 进行适度的运动
  • 减少饮食中的饱和脂肪
  • managing underlying health conditions, such as thyroid diseases

这 American Heart Association 建议20岁以上的每个人每四到六岁一次进行胆固醇测试。如果您有高胆固醇的危险因素，例如家族史，则可能需要更频繁地测试。

需要进行更多的研究，以进一步了解HDL对某些人有多么有害。如果您有高胆固醇水平或C反应性蛋白质的个人或家族史，请与您的医生讨论可以定期监测HDL水平的步骤。

问：

在过去的一年中，我心脏病发作。我应该担心我的HDL水平吗？

匿名病人

A：

您的HDL级别是心血管风险的重要组成部分，您绝对应该咨询医生。如果您的HDL水平低于美国心脏协会建议的水平，您的医生可能会开出新的药物或调整现有药物以帮助增加它并降低心血管风险。

格雷厄姆·罗杰斯（Graham Rogers），医学博士 Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.