From the Guidelines
An HDL cholesterol level of 137 mg/dL is considered high and generally beneficial for cardiovascular health, and no specific treatment is needed to lower this level. This high level of HDL cholesterol is often referred to as "good cholesterol" because it helps remove other forms of cholesterol from your bloodstream, thereby reducing the risk of cardiovascular disease 1. You should continue your current healthy lifestyle habits that may be contributing to this favorable level, including:
- Regular physical activity, which has been shown to improve the lipid profile and increase HDL cholesterol levels 1
- Maintaining a healthy weight, which can help reduce the risk of cardiovascular disease
- Consuming a diet rich in fruits, vegetables, whole grains, and healthy fats (like those found in olive oil, nuts, and fatty fish)
- Avoiding smoking, which can lower HDL cholesterol levels and increase the risk of cardiovascular disease
If you're taking medications that raise HDL, such as niacin or certain fibrates, continue them as prescribed by your doctor. This high HDL level likely provides some protection against heart disease by helping transport excess cholesterol from your arteries to your liver for removal from the body. However, very high HDL levels (above 90-100 mg/dL) have shown diminishing returns in some research, so it's still important to manage other cardiovascular risk factors like LDL cholesterol, blood pressure, and blood sugar 1.
It's also important to note that a high HDL level does not necessarily mean that you are not at risk for cardiovascular disease, as other factors such as family history, age, and lifestyle habits can also play a role. Therefore, it's essential to continue monitoring your overall cardiovascular health and making lifestyle changes as needed to reduce your risk of cardiovascular disease.
From the Research
Significance of High-Density Lipoprotein (HDL) Level of 137
- An HDL level of 137 is considered very high, and its significance can be understood by looking at the relationship between HDL levels and cardiovascular risk.
- According to a study published in 2019 2, extremely high levels of HDL cholesterol (>90 mg/dl) have been associated with lower risks of all-cause mortality and cardiovascular events compared to low levels, but higher risks compared to very high levels.
- Another study from 2022 3 found that very high HDL-C levels (>80 mg/100 ml) were associated with increased risk of all-cause death and cardiovascular death in men, but not in women.
- The role of HDL in cardiovascular risk determination is complex, and recent research suggests that a raised functional capacity of HDL, rather than elevated levels per se, may be responsible for the postulated cardiovascular protection 4.
- It is also important to note that HDL-C is not considered a therapeutic target at present, and risk stratified atherogenic lipoprotein burden should remain the primary and secondary targets of therapy in patients at risk 5.
HDL Levels and Cardiovascular Risk
- The relationship between HDL levels and cardiovascular risk is U-shaped, with both low and very high levels associated with increased risk 4.
- A study from 2020 6 highlighted the complexity of HDL metabolism and function, and the need for further research into the therapeutic potential of HDL-based treatments.
- The National Lipid Association has emphasized the need for rigorous research into the biology and clinical significance of low HDL-C, and the development of novel drugs designed to modulate the serum levels and functionality of HDL particles 5.