Maintaining adequate levels of high density lipoprotein (HDL), often referred to as the "good" cholesterol, can help protect against developing heart disease. The first steps that can be taken to raise concentrations of this substance in the blood are to make dietary changes, lose weight, quit smoking, exercise regularly, and regulate alcohol intake. If these changes do not work, medications such as fish oil capsules, nicotinic acid, and gemfibrozil can be tried. Patients with low HDL should avoid taking medications that might further decrease their blood levels. In general, patients should aim to have an HDL level of at least 60 mg/dL.
Often the first method used to increase blood HDL is to make dietary changes. Patients should decrease their intake of saturated fats and aim to replace them with monosaturated fats. Calories derived from fats should account for less than 35% of total caloric intake. Some research has shown that the omega-3 fatty acids, including long-chain n-3 polyunsaturated fatty acids (n-3 PUFA), docosahexaenoic acid (DHA), and eicosapentaneoic acid (EPA), can help increase the blood's HDL concentration while lowering triglyceride levels. These beneficial fats are found in foods such as fish, flaxseed oil, and nuts.
Making other lifestyle changes can also help raise HDL levels. If patients are overweight, they should try to lose weight, as obesity can contribute to lowering levels of this blood lipid. Smokers are advised to quit smoking. Performing regular physical exercise is another lifestyle modification that can contribute to increasing HDL; although the exact type of physical activity undertaken isn't too important, patients should aim for performing aerobic exercises that increase the heart rate for 30 minutes, five times a week. While moderate alcohol consumption, especially in the form of red wine, can slightly raise the levels of this cholesterol type, excessive alcohol intake should be avoided.
Some patients fail to have a large enough increase in their "good" cholesterol after making these changes. If this is the case, a number of medications can be given in an attempt to raise these levels. Over-the-counter fish oil capsules, which contain the beneficial omega-3 fatty acids, are one pharmaceutical option. Taking nicotinic acid pills is another step that can increase this blood cholesterol level. The prescription-only drug class known as the fibrates, including medications such as gemfibrozil, can also be used.
Another aspect of maintaining ideal HDL cholesterol levels is to avoid medications that could cause decreases in this substance. Depending on the patient's other health issues, this might be difficult. If possible, however, medication such as beta blockers, androgens, and benzodiazepines should be avoided.
The level of HDL in the blood is often checked as part of cholesterol screening test. Most doctors recommend patients to aim for a blood level of at least 60 mg/dL. Women with levels lower than 50 mg/dL and men with values less than 40 mg/dL are considered to have low levels. These patients should attempt to increase the concentration of this substance in their blood.