To screen for risk of developing cardiovascular disease (heart disease, stroke and related diseases); to monitor treatment
HDL Cholesterol Test
Aged 40 as part of a routine cardiovascular health check, or if you are already thought to be at risk of cardiovascular disease for another reason.
A blood sample taken from a vein in the arm or from a finger-prick
No fasting is needed for an HDL-cholesterol test. However, you should follow your doctor's advice as fasting might be needed for other tests being performed.
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How is it used?
HDL-cholesterol testing is usually used to help find out your risk of developing cardiovascular disease. If you have a high cholesterol, your doctor may wish to know if this is mainly due to non-HDL cholesterol (bad) or to HDL-cholesterol (good). Usually it due to having high non-HDL cholesterol, unfortunately.
Your HDL-cholesterol can be used, along with total cholesterol and other factors, in "risk calculators" such as QRISK2, which estimate your future risk of getting cardiovascular disease. The value which is entered into the calculator is actually the "total cholesterol to HDL-C ratio", ie the balance between total cholesterol and good cholesterol. Knowing your future risk can guide decisions on making lifestyle changes or starting medical treatments.
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When is it requested?
HDL is usually requested with other tests, either with cholesterol or as part of a lipid profile, including non-HDL and triglycerides. This is done during a routine cardiovascular risk assessment, which GPs offer to people aged 40 or over. If your doctor thinks you could be at higher risk of cardiovascular disease for another reason, they may recommend HDL testing at other times.
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What does the test result mean?
High levels of HDL cholesterol are better than low HDL cholesterol. The higher your HDL cholesterol level, the lower risk of developing cardiovascular disease. This is because HDL carries cholesterol away from the artery walls and back to the liver, where it is eliminated.
Other factors can affect your HDL cholesterol result. For example, physical exercise and moderate alcohol consumption increase your HDL cholesterol, whereas smoking reduces it.
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Is there anything else I should know?
HDL cholesterol should not be measured when a person is suddenly unwell. Cholesterol is temporarily low during sudden illness, immediately following a heart attack, or during stress (like from surgery or an accident). You should wait at least 6 weeks after any illness to have cholesterol measured. In women, HDL cholesterol may change during pregnancy. You should wait at least six weeks after your baby is born to have your HDL-cholesterol measured.
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My HDL is high. Is this a problem?