How do I raise my HDL?
Move. Across 25 trials, regular walking, cycling, running or swimming raised HDL by about 2.5 mg/dL, and longer sessions raised it more. But don’t chase the number with pills. The 2026 guideline sets its goals for LDL and non-HDL, not HDL.
What we’d do
Exercise for your heart and let HDL come along for the ride. Aim for at least 150 minutes a week, and make sessions longer before you make them harder. Then put your real effort into LDL and non-HDL. In a large trial, a drug that pushed HDL up didn’t prevent heart attacks. A higher HDL goes with good habits, and raising it on purpose hasn’t been shown to protect you.
Why people chase it
HDL got the nickname “good cholesterol”, and people with low HDL do have more heart disease. It seems to follow that raising it would protect you. A high HDL is more like a good credit score. It reflects good habits, but you can’t spend the score itself.
What raises it
In a 2007 review of 25 trials, aerobic exercise raised HDL by 2.53 mg/dL on average. The details are useful:
- About 120 minutes a week was the smallest amount that moved it, or about 900 calories of exercise.
- Each extra 10 minutes per session added about 1.4 mg/dL.
- How often and how hard didn’t make a clear difference. Session length did.
- Leaner people (a BMI under 28) with a total cholesterol of 220 or more saw about 2 points more.
A larger pool of 148 exercise trials in the 2026 guideline found HDL up about 2.1, LDL down about 7 and triglycerides down about 8.
Why a pill that raised HDL fell flat
In the AIM-HIGH trial, published in 2011, 3,414 people with heart disease and low HDL, all on a statin, took niacin or a placebo. Niacin did what it was supposed to. HDL rose from 35 to 42 and triglycerides fell from 164 to 122. After 3 years, heart attacks, strokes and deaths were the same in both groups (16.4% against 16.2%), and the trial was stopped early.
Alcohol is the other famous HDL raiser. About 2 drinks a day raised HDL by 4 points in 42 studies, more than exercise did, and it raised triglycerides too. Nobody should drink for their HDL.
When HDL is low
NCHS counts an HDL under 40 mg/dL (1.0 mmol/L) as low. In 2021 to 2023, 13.8% of US adults were under it, 21.5% of men and 6.6% of women, down from 22.2% of adults in 2007 to 2008. A low HDL often travels with high triglycerides and extra weight, so the same changes help all three. Your HDL also feeds into your non-HDL, which is your total minus your HDL and does have a goal.
For exercise and your heart’s rhythm, see does exercise increase HRV? on hrv.guide.
6 sources
- Kodama S and others, Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol, Archives of Internal Medicine, 2007pubmed.ncbi.nlm.nih.gov
- Blumenthal RS, Morris PB, Gaudino M and others, 2026 ACC/AHA guideline on the management of dyslipidemia, JACC, 2026doi.org
- The same guideline, full text, Circulation, 2026api.iscpcardio.org
- AIM-HIGH Investigators, Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy, New England Journal of Medicine, 2011pubmed.ncbi.nlm.nih.gov
- Rimm EB, Williams P, Fosher K, Criqui M and Stampfer MJ, Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors, BMJ, 1999pubmed.ncbi.nlm.nih.gov
- CDC NCHS Data Brief 515, Total and high-density lipoprotein cholesterol in adults: United States, August 2021 to August 2023cdc.gov
