HDL vs. LDL: What’s the Difference?

In conversations about cholesterol, the terms HDL and LDL always take center stage. That’s for good reason. These tiny particles play a big role in managing heart disease risk.

But when you’re looking over your blood test results, the letters and numbers might start to blur together, making it hard to remember what HDL and LDL mean and how they differ.

Cardiologist Abhayjit Singh, MD, is here to help, outlining what you need to know about HDL and LDL in simple terms.

Dr. Singh shares why HDL particles are “good,” and LDL particles are “bad” — and why the distinction matters for your heart health.

Defining HDL and LDL

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Dr. Singh says that while most people use “HDL” as shorthand for “HDL cholesterol,” they’re not the same thing. The same goes for “LDL” and “LDL cholesterol."

“HDL” stands for high-density lipoprotein. “LDL” stands for low-density lipoprotein. Lipoproteins are particles in your blood that carry proteins and fats, including cholesterol. That means:

• “HDL cholesterol” is all the cholesterol carried on HDL particles.
• “LDL cholesterol” is all the cholesterol carried on LDL particles.

Why does this matter?

“HDL and LDL aren’t different types of cholesterol. Cholesterol is all the same whether it’s attached to an LDL or an HDL particle,” explains Dr. Singh. “But the particles are different. HDL particles are often called ‘good’ and LDL particles ‘bad’ because of what they tend to do with the cholesterol they carry.”

Lipid panels measure the mass of cholesterol on each type of lipoprotein. Dr. Singh says that’s generally a pretty good stand-in for the number of particles in your blood for most people. Your test results will list your cholesterol levels as milligrams of cholesterol per deciliter of blood (mg/dL).

HDL vs. LDL

HDL and LDL particles differ in several ways, including their:

• Role in heart health
• Role in treatment
• Healthy levels

The table below offers a quick snapshot of these differences before we dive deeper.

Role in heart health

LDL particles deposit cholesterol in your arteries. This contributes to plaque formation — which can clog your arteries and lead to heart attacks, stroke and other problems.

HDL particles do the opposite. They search for extra cholesterol in your blood and carry it to your liver. From there, it leaves your body rather than sticking around in your arteries.

Dr. Singh offers an analogy to help you picture what’s happening. To start, think of your arteries like a network of roads.

“LDL particles are like delivery trucks,” he illustrates. “If there are too many of them, they can crash and spill their contents everywhere. Your HDL particles are the cleanup crew that carries away the mess and clears a path.”

You can also use the first letter of each term to remember the difference:

• “H” for helpful
• “L” for lousy

It’s important to note that while HDL particles are helpful, they’re not superheroes. They can’t clean up all the messes all the time. That’s why lowering your LDL is more beneficial in the long run than raising your HDL. A high HDL can’t cancel out the risks associated with a high LDL.

“There’s this common belief that it’s all about balance — that if you have a high LDL but also a high HDL, you’ll be OK,” Dr. Singh notes. “But that’s not true.”

He further explains, “If you have a high LDL — lots of delivery trucks spilling stuff — it doesn’t matter how many cleaning crews you have. Or how good they are. Some plaque will still get left behind in your arteries. So, you need to get those trucks off the road.”

Role in treatment

Your healthcare provider may prescribe medicine to lower your LDL and reduce your cardiovascular risk. But they won’t prescribe medicine to raise your HDL. That’s because studies haven’t shown any benefit to HDL-raising medications.

“We have effective medications that lower your LDL and, in turn, reduce your risk of heart attack or stroke,” Dr. Singh says. “However, the same isn’t true for HDL. Research shows that raising HDL with medications doesn’t reduce your risk.”

Instead, it’s best to raise your HDL in other ways — like through heart-healthy foods and exercise. Such efforts can increase your HDL plus reduce your cardiovascular risk.

“A higher HDL is associated with a healthier heart, but it doesn’t necessarily cause a healthier heart,” Dr. Singh clarifies. “It’s more likely that the things you’re doing to raise your HDL are helping you in so many other ways, too. Like lowering your blood pressure and blood sugar. Those benefits add up over time.”

Healthy levels

The exact HDL and LDL numbers to target can vary from person to person. Your healthcare provider will help you understand what’s best based on your health history. The table below lists general targets.

A couple of things to keep in mind:

• A very high HDL cholesterol (above 80 mg/dL) may sometimes be linked with HDL that doesn’t work as expected. Studies have found that very high HDL levels can be associated with increased heart disease risk.
• An LDL below 100 mg/dL is a good target for most adults. But some people need to aim even lower based on their age and heart disease risk factors, like high blood pressure or a history of a heart attack or stroke.

Ways to increase your HDL and lower your LDL

Sure, HDL and LDL have many differences. But one thing they have in common? Both types of particles respond to things you do in your daily life, like what you eat and how much you move around. Dr. Singh offers some tips.

• Diet: To raise your HDL cholesterol, add foods — like fish, whole grains, legumes and avocado. To lower your LDL, remove foods — like ultra-processed foods and those high in saturated fat or sugar. Following the Mediterranean diet can help.
• Exercise: Aim for at least 150 minutes of moderate-intensity exercise per week. This can help lower your LDL and raise your HDL. Once 150 feels too easy, aim for 200 minutes. Or add high-intensity workouts, like HIIT or Tabata, to build endurance.

When you’re looking to make changes, it’s always a good idea to speak with a healthcare provider first. They’ll make sure your diet or exercise plans are safe and helpful for you. They can also offer guidance and encouragement along the way.