My HDL is low — what should I do?
Low HDL is a marker of metabolic and cardiovascular risk but is not a direct treatment target. Address insulin resistance, adiposity, smoking, and inactivity. Pharmacologic HDL-raising therapies have not shown outcome benefit.
Full answer
Low HDL is a robust marker of metabolic dysfunction and cardiovascular risk but is not, on current evidence, a useful pharmacologic target — niacin and CETP inhibitors have not delivered outcome benefit. The intervention is on the underlying driver: visceral adiposity, insulin resistance, smoking, alcohol excess, and inactivity. Aerobic training, weight optimization, and smoking cessation reliably raise HDL. ApoB and the rest of the lipid panel guide treatment decisions. The metabolic pathway integrates this read with the broader cardiometabolic baseline.
Educational. Not a substitute for individualized provider review.
- Methodology — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03