Q: Does having high HDL cholesterol cancel out having high LDL cholesterol?
A: No, HDL does not necessarily “cancel out” LDL. LDL stands for low-density lipoprotein, which is the bad cholesterol. This is the cholesterol that builds plaque on the inside of your carotid arteries, in your heart, in your aorta and in other blood vessels. Your HDL, which is high-density lipoprotein, is the good cholesterol. That one is important in reducing the plaque and taking it back to the liver. Clinical trials show us that when the HDL is low, raising it with medicine does not reduce your risk of heart disease. Therefore, if you have a high HDL and your LDL is also high, then you have not necessarily cancelled out your risk of heart disease just because your HDL is high. So we focus on driving the LDL as low as we need to, depending on your risk. That way, we prevent further plaque build-up and reduce your risk of heart disease.
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— Preventive cardiologist Haitham Ahmed, MD, MPH