HDL serves as a chemical shuttle that transports excess cholesterol from peripheral tissues to the liver. This pathway is called the RCT system. In this system, plasma HDL takes up cholesterol from the peripheral tissues, such as fibroblasts and macrophages. (A study by El Khoury et al indicated that in persons with HALP, macrophages have an increased plasma cholesterol efflux capacity.  ) This may occur by passive diffusion or may be mediated by the adenosine triphosphate (ATP)–binding cassette transporter 1. The latter interacts directly with free apo A-I, generating nascent, or so-called discoidal, HDL. Cholesterol undergoes esterification by lecithin-cholesterol acyltransferase (LCAT) to produce cholesteryl ester, which results in the production of the mature spherical HDL. Cholesterol is also taken up from triglyceride-rich lipoproteins in a process mediated by a phospholipid transfer protein (ie, CETP). [19, 20, 21, 22]
115 my triglycerides being 456 and my HDL cholesterol that I 35 and then my LDL direct is 256 my family is known for heart disease and plaque buildup nine really don’t want that to happen so any advice would be appreciated I already limit my diet really well with vegetables and fruits and I eat a lot of pork and chicken and I’m allergic to fish so I can eat fish is there anything I can do to replace that thank you for your time have a wonderful day
HDL levels below 40 mg/dL are associated with an increased risk of CAD, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60 mg/dL are considered "normal," and do not very much affect the risk of CAD one way or the other. However, HDL levels greater than 60 mg/dL are actually associated with a reduced risk of heart disease.
A: Before I answer that question, why bother to increase HDL cholesterol at all? Many studies have found that people with low levels of HDL are at increased risk for heart attacks, strokes, and other complications of arteries diseased by atherosclerosis: that's why we call HDL the "good" cholesterol. Given that, you'd think that raising HDL levels would reduce a person's risk for atherosclerosis. Unfortunately, despite a lot of research, we don't yet know if that's true, nor how best to raise HDL levels.
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Tree nuts, such as walnuts, pistachios and pecans, have been shown to lower both total cholesterol and "bad" LDL cholesterol. Nuts are high in heart-healthy monounsaturated fat, fiber and several vitamins and minerals that are good for heart health. Nuts also contain plant sterols, which are natural compounds that block the cholesterol you eat from entering your bloodstream. While nuts are awesome to eat, don't go crazy. Portion control is still important—there are 163 calories in just 1 ounce of almonds. Add a small handful to oatmeal, top toast with nut butter or make a DIY trail mix with dried fruit and nuts.
Research shows that there isn't really a link between how much fat you eat and your risk of disease. The biggest influence on your risk is the type of fat you eat. Two unhealthy fats, including saturated and trans fats, increase the amount of cholesterol in your blood cholesterol and increase your risk of developing heart disease. However, two very different types of fat — monounsaturated and polyunsaturated fats — do just the opposite. In fact, research shows that cutting back on saturated fat and replacing it with mono and polyunsaturated fats can help lower the level of LDL cholesterol in your blood.
Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
The good news is that changing your cholesterol levels is well within your control as some of the smallest lifestyle tweaks can yield a profound impact. A fast track to boosting HDL includes quitting smoking and increasing physical activity. The American Heart Association recommends 30 minutes of moderate physical activity at least 5 times per week with two sessions of resistance training. Your choices at mealtimes, however, may prove to be an easier more attainable way to make lasting change. Here are the foods that raise HDL cholesterol.
Can my HDL be too high? It is well known that not all cholesterol is bad for you. Of HDL and LDL cholesterol, HDL packs some great benefits. This MNT Knowledge Center article examines when high HDL cholesterol is good, and whether higher is always better? Learn how to find the right balance along with some healthful ways to achieve high HDL. Read now
Niacin can be taken at lower doses rather than prescription levels, but supplementation can cause unwanted niacin side effects, especially when taking at high dosages. Some negative results of taking niacin include experience flushing, an uncomfortable feeling of heat, itching or tingling in the skin. Other side effects can include gastrointestinal, muscle and liver problems.
First, a quick explainer: Cholesterol is a waxy substance that travels through your bloodstream, but not all of it is bad. HDL cholesterol (a.k.a. "good" cholesterol) actually sweeps away LDL cholesterol, or the "bad" kind. A high LDL level puts you at risk for heart attacks and strokes because it can clog arteries with plaque, a condition called atherosclerosis. A blood test can determine whether you have high cholesterol, and your doctor may recommend exercise or medication in addition to a healthier diet.
As defined by the US National Cholesterol Education Program Adult Treatment Panel III guidelines, an HDL cholesterol (HDL-C) level of 60 mg/dL or greater is a negative (protective) risk factor.  On the other hand, a high-risk HDL-C level is described as being below 40 mg/dL. Randomized, controlled clinical trials have demonstrated that interventions to raise HDL-C levels are associated with reduced CHD events. A prospective analysis by Mora et al investigated the link between cholesterol and cardiovascular events in women and found that the baseline HDL-C level was consistently and inversely associated with incident coronary and coronary vascular disease events across a range of LDL-C values. 
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society