What are the different types of cholesterol?

Cholesterol travels throughout the body in little packages called lipoproteins which are made up of blood fats called lipids and proteins. Two main types of lipoproteins carry cholesterol:

  • Low-density lipoprotein-cholesterol (LDL-C) is known as the “bad” cholesterol because it carries cholesterol to tissues, including the arteries. You might think of low-density lipoprotein (LDL) as being the bad “dump truck.” LDL cholesterol is the amount of cholesterol fat circulating in your blood, which can be used to estimate the number of LDL dump trucks getting into the artery wall—the cause of plaque build-up and driving force behind atherosclerosis, heart disease and stroke.
  • High-density lipoprotein-cholesterol (HDL-C) is known as the “good” cholesterol because it helps take “bad” cholesterol out of the body. Think about HDL-C as a “tow truck” that removes LDL-C from your blood. The higher your HDL-C level, the more “bad” cholesterol your body can remove. Research has shown that for every one mg/dL increase in HDL-C, your risk of a heart attack drops 3 to 4 percent. Because studies have shown that low HDL-C may be a greater risk factor for heart disease in women, guidelines for healthy HDL-C levels differ for men and women.

There are three basic types of cholesterol in the body: low-density lipoproteins (LDL), high-density lipoproteins (HDL) and very-low-density lipoproteins (VLDL). Because the VLDL level is rarely measured directly, cholesterol tests generally measure total cholesterol, LDL and HDL cholesterol. (LDL is calculated by subtracting HDL from total cholesterol.) LDL cholesterol causes aging of the arteries; HDL cholesterol prevents it. HDL is the healthy cholesterol that takes the lousy cholesterol from your bloodstream back to the liver and out of the body as waste products. (I remember the "L" of LDL as "lousy" and the "H" of HDL as "healthy.")

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We've realized in the past several years that the overall cholesterol number isn't nearly as important as breaking it down into LDL and HDL because the two have such different actions.

We remember it by first initials: L for lousy, H for healthy.

LDL cholesterol is short for low-density lipoprotein cholesterol. Exercising, losing even 10 pounds of weight, avoiding simple carbohydrates (avoid all white foods), and restricting saturated and trans fats to less than 20 grams a day will lower your LDL. You can lower the level of LDL cholesterol in several other ways, as well.

As you might guess, HDL cholesterol is short for high-density lipoprotein cholesterol. You want as high an HDL level possible—at least greater than 40. You can increase your HDL by consuming healthy fats-found in olive oil, fish, and walnuts-walking (or any physical activity) for 30 minutes a day, taking a newer statin (such as Lipitor or Crestor), and having a drink of alcohol every night (seven on Saturday night doesn't count). You can boost your level of HDL cholesterol in other ways, as well.

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Cholesterol travels in the blood in packages called lipoproteins, which consist of lipids (fats) and protein. Cholesterol packaged in low-density lipoprotein (LDL) is often called "bad" cholesterol because too much LDL in the blood can lead to cholesterol buildup and blockage in the arteries. LDL carries most of the cholesterol in the blood.

Another type of cholesterol package is high-density lipoprotein (HDL), often called "good" cholesterol. HDL helps transport cholesterol from other parts of the body to the liver, which helps remove it from the body, preventing it from piling up in the arteries.

A third type of lipoprotein is very low density (vLDL). This package transports triglycerides in the blood; high levels of vLDL and triglycerides have also been linked to an increased risk of heart disease. There is no direct way to measure vLDL cholesterol, so it's normally not mentioned during routine cholesterol screenings. The vLDL measurement is usually estimated as a percentage of your triglyceride value, with a normal value between five and 40 mg/dL.

Dr. Ozgen Dogan
Cardiologist (Heart Specialist)

There are three kinds of cholesterol. I like to categorize them according to an old cowboy film: The Good, the Bad and the Ugly. GOOD=HDL (high-density lipoprotein), BAD=LDL (low-density lipoprotein), UGLY=triglycerides. Here's LDL's role: it takes cholesterol from the liver and carries it to our tissues and organs. Plaques are formed by LDL. The good cholesterol, HDL, takes cholesterol from our veins and carries it to the liver where it is discarded through our intestines. HDL's job prevents the formation of plaques. Triglycerides are another type of fat found in our blood. If they exceed normal levels, they are also harmful, although not as harmful as LDL. Triglyceride levels can be high in people who have poorly managed diabetes, are taking certain medications and/or are obese.

Some cholesterol comes from the foods you eat, but most is made by your liver and comes in two basic forms: low-density lipoprotein (LDL) or high-density lipoprotein (HDL). LDL particles carry and deliver cholesterol to cells throughout the body; HDL particles mop up excess cholesterol and carry it back to the liver for disposal. If the body produces more LDL cholesterol than the cells can absorb, the excess settles in artery walls and contributes to atherosclerotic plaque. That's why LDL is often called "bad" cholesterol and HDL "good" cholesterol—even though the body needs both.

Cholesterol is a form of fat that is carried through the body in two kinds of bundles, or lipoproteins. It's important to have healthy levels of both.

Low-density lipoproteins (LDLs), or "bad" cholesterol, can lead to a buildup of cholesterol in the arteries. In general, the lower your LDL, the better. Reaching your LDL target is the most effective way to protect your heart and blood vessels.

High-density lipoproteins (HDLs), or "good" cholesterol, helps remove cholesterol from your body. In general, the higher your HDL, the better.

Dr. Marcus J. Cox, MD
Cardiologist (Heart Specialist)

LDL is considered the “bad cholesterol” and can increase the risk of heart disease. The HDL, or “good” cholesterol may offer protection from heart disease. Triglycerides may also be checked and is a type of fat in the blood, which can also increase someone’s risk of heart disease.

The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Dr. Jack Merendino, MD

Cholesterol and triglycerides are the two major forms of fat that circulate in the blood, and together they are referred to as lipids. You know that oil and water don't mix, and so it is with cholesterol or triglycerides and blood. These fats don't dissolve in the blood, but are packaged into particles along with special proteins. There are different types of particles, and each has a different metabolic part to play. The major particles are termed high-density lipoprotein, or HDL; low-density lipoprotein, or LDL; and very-low-density lipoprotein, or VLDL.

All cholesterol is chemically the same, but when it's packaged in one type of particle it does one thing, and when packaged in a different kind of particle it does another. HDL particles help remove cholesterol from the linings of blood vessels, so the higher the HDL cholesterol level, the lower the risk of heart disease. HDL is usually termed "good" cholesterol for this reason. LDL particles put more cholesterol into the plaques lining arteries, so the higher the LDL cholesterol level, the greater the risk of heart disease. LDL cholesterol is therefore called "bad" cholesterol. VLDL particles contain mostly triglycerides. HDL cholesterol levels of 40 mg/dL or more for a man and 50 or more for a woman are generally considered normal, but the higher you go the better off you are. Similarly, LDL cholesterol levels should be less than 100 to be normal, but there is evidence that even lower values help reduce your risk of heart disease.

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Cardiologist (Heart Specialist)

HDL cholesterol is the amount of cholesterol carried by HDL particles, which are involved in eliminating excess cholesterol from the blood vessel walls throughout the body; and LDL cholesterol is the amount of cholesterol carried by LDL particles, which are involved in delivering cholesterol to tissues throughout the body to make membranes around your cells, making hormones that are necessary for normal sexual development, aiding in salt and water balance, making vitamins and making bile to help us to digest our food.

There are two main types of cholesterol: "bad" LDL (low-density lipoprotein) and "good" HDL (high-density lipoprotein). The more HDL you have, the better it is for your heart disease risk, because HDL transports cholesterol away from tissues to the liver and out of your body. You want low LDL and high HDL. For otherwise healthy people, HDL levels should be at least 40. But your HDL goal will differ, depending on your unique medical situation. If you have other health risk factors, your doctor may want yours to be higher. Work with your doctor to determine what your HDL and LDL goals should be.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.