LDL Vs HDL Cholesterol: Experts Explain The Differences

Just like ‘good cop’ and ‘bad cop’, cholesterol too has two versions or avatars. These are LDL aka ‘bad cholesterol’ and HDL aka ‘good cholesterol’. What exactly are these, why are they important for our body, and how do they differ from each other? This article will explain all this for you.

To get a better understanding of this, the editorial team of OnlyMyHealth reached out to Dr Arun Chopra, Director Cardiology, Fortis Escorts Hospital, Amritsar and Dr Sanjay Bhat, Senior Consultant - Interventional Cardiology, Aster CMI Hospital, Bangalore.

What Is LDL Cholesterol?

“Cholesterol is a type of fat in the blood that the body needs to build cells and make hormones, but too much of it can be harmful. There are two main types of cholesterol called LDL and HDL, and they affect the body in different ways,” says Dr Bhat. 

LDL cholesterol is the short form for low-density lipoprotein. As per Centers for Disease Control and Prevention (CDC), this is often termed the 'bad' cholesterol because high levels of LDL cholesterol raise your risk for heart disease and stroke. Explaining this further, Dr Bhat shares, “LDL is often called ‘bad cholesterol’ because it carries cholesterol from the liver to different parts of the body. If there is too much of it, it can stick to the walls of the blood vessels. Over time, this forms plaque, which can narrow or block the arteries. This increases the risk of heart problems like heart attack and strokes.”

What Is HDL Cholesterol?

HDL stands for high-density lipoprotein cholesterol. According to the CDC, this is often called 'good' cholesterol because it absorbs cholesterol in the blood and carries it back to the liver, which then flushes it from the body. High levels of HDL cholesterol can reduce your risk for heart disease and stroke. 

Shedding more light on this, Dr Bhat explains, “HDL is known as ‘good cholesterol’ because it helps remove extra cholesterol from the blood and carries it back to the liver, where it is broken down and removed from the body. This process helps keep the blood vessels clear and reduces the risk of heart disease.”

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LDL Vs HDL Cholesterol: What's The Difference?

Now that we know what LDL and HDL cholesterol is, let us understand their differences. Dr Chopra explains, “‘Bad cholesterol’ or LDL transports cholesterol from the liver to other parts of the body. When there is too much bad cholesterol in the body, it leads to cholesterol building up in artery walls. Eventually, this leads to plaque building up in arteries, which causes heart attack and stroke. ‘Good cholesterol’ or HDL works in the body like a cleanup crew. This cholesterol picks up extra cholesterol in the bloodstream and artery walls and takes it back to the liver for excretion. High levels of HDL are good for the heart.”

Dr Bhat sheds more light on this and says, “In simple terms, LDL adds cholesterol to the arteries, while HDL removes it. So, having high LDL levels is harmful, and having high HDL levels is helpful for heart health. A healthy balance is important. Ideally, LDL levels should be low, and HDL levels should be higher. Doctors usually check these levels through a blood test called a lipid profile. To manage cholesterol, it is important to eat healthy foods like fruits, vegetables, whole grains, and nuts, and avoid too much fried and processed food. Regular exercise, maintaining a healthy weight, and avoiding smoking also help improve cholesterol levels.”

What Are Normal Cholesterol Levels?

What is the normal range of LDL and HDL cholesterol levels? “From a health perspective, the goal is simple, to keep LDL levels low and HDL levels high. This can be achieved through a balanced diet, regular exercise, maintaining a healthy weight, and avoiding smoking. Understanding this difference is important because it shifts the focus from fearing cholesterol to managing it wisely for better heart health,” explains Dr Chopra.

According to the Cleveland Clinic, normal cholesterol levels differ based on factors such as age, ethnicity, and sex. It lists down the range which medical professionals consider normal for most adults:

• Total cholesterol: Below 200
• LDL cholesterol: Below 100
• VLDL cholesterol: Below 30
• HDL cholesterol: 40-80 (males), 50-80 (females)

A report in Harvard Health mentions that the lower the level of LDL, the better; the goal is to keep it less than 130 mg/dL if you don't have atherosclerotic disease or diabetes. And for HDL, the report mentions that it should be higher than 55 mg/dL for women and 45 mg/dL for men. It adds that the higher your HDL cholesterol numbers, the lower your risk for heart disease, vascular disease, and stroke.

Common Myths About Cholesterol Debunked

There are many myths surrounding cholesterol. The Centers for Disease Control and Prevention (CDC) and the American Heart Association share some of these myths and separate them from facts. Let’s take a look:

Myth 1: Cholesterol is bad for you

Fact: Some types of cholesterol are crucial for good health and overall wellbeing. Your body needs cholesterol to perform some of its important tasks like making hormones and building cells. 

Myth 2: Diet and physical activity are the deciding factors for cholesterol levels

Fact: Healthy lifestyle habits such as eating a heart-healthy diet and getting regular activity definitely help lower LDL. However, factors such as age, overall health, family history, diabetes, and past heart attack or stroke also play a key role in dictating your cholesterol levels.

Myth 3: Slim individuals cannot have high cholesterol

Fact: Individuals of any body type can have high cholesterol. Being overweight may increase your chances of high LDL cholesterol, but being slim doesn’t necessarily guarantee that your cholesterol levels will be in control. 

Myth 4: Eating cholesterol-rich foods will not spike cholesterol levels

Fact: Cholesterol-rich foods usually have a lot of saturated fat, which can make your cholesterol numbers higher; therefore, it's best to choose foods that are lower in saturated fats and aim to follow a balanced diet.

When To See A Doctor

The American Heart Association recommends that children should get their cholesterol levels checked once between the ages of nine and 11. The next cholesterol screening is recommended between ages 17 and 21. Thereafter, many adults get their cholesterol checked every 4 to 6 years. Individuals who have health conditions like high blood pressure or diabetes may need to get screened more regularly. It further noted that people who take medicine for high cholesterol require regular cholesterol testing, which can help healthcare professionals track how efficiently their treatments are working.

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Conclusion

LDL or low-density lipoprotein is known as ‘bad cholesterol’ because it carries cholesterol from the liver to different parts of the body. If there is too much of it, it can stick to the walls of the blood vessels. On the other hand, HDL aka high-density lipoprotein is often called ‘good’ cholesterol because it absorbs cholesterol in the blood and carries it back to the liver, which then flushes it from the body. Keeping LDL low and HDL high can help protect the heart and improve overall health.