VLDL cholesterol is a “bad” form of cholesterol because, in excess, it causes plaque buildup (atherosclerosis) in your arteries. A normal VLDL level is below 30 mg/dL. Your healthcare provider can measure your VLDL cholesterol through a simple blood test. If your VLDL is high, lifestyle changes and medication can help.
Lipoproteins are particles that transport lipids (fats) in your blood. Due to their chemical structure, fats (like cholesterol and triglycerides) can’t travel solo through your blood. That’s why they need lipoproteins to carry them to various organs and tissues throughout your body.
The main job of VLDL is to carry triglycerides and cholesterol to the places that need them. In their transport role, VLDLs help your body gain energy, store energy and regulate blood pressure. So, they’re important for your overall body function. But having too many VLDLs in your blood can be dangerous and raise your risk of cardiovascular disease.
VLDL particles contain mostly triglycerides (a form of fat). They also contain cholesterol, fatty acids and a form of protein called apolipoprotein B (apoB). Research has linked high levels of apoB in your blood with increased risk for cardiovascular disease.
All lipoproteins are made of fats and proteins. But the chemical makeup differs based on the specific type of lipoprotein. For example, each type of lipoprotein contains different amounts of fat and protein, as well as different forms of each. Researchers call VLDLs “triglyceride-rich lipoproteins” because of their high triglyceride content.
Most people use “VLDL” and “VLDL cholesterol” interchangeably. But there’s a difference worth knowing.
VLDL refers to the lipoprotein, or the particle, that your liver creates. This particle transports fats and proteins in your blood. VLDL is a bit like a bus. The passengers on the bus include the different fats and proteins that need a ride. Cholesterol is one of those passengers. VLDL cholesterol refers to the cholesterol that’s carried on VLDL particles throughout your blood.
Other types of lipoproteins, like LDLs and HDLs, also serve as buses. They each carry different amounts and forms of fat and protein. LDL cholesterol refers to the cholesterol that LDL particles carry. Similarly, HDL cholesterol refers to the cholesterol that HDL particles carry.
VLDL cholesterol is “bad” when there’s too much of it in your blood. You need some to support your body’s needs. But high levels of VLDL cholesterol can raise your risk of atherosclerosis (buildup of plaque in your arteries).
When your liver produces more VLDLs than you need, your body has to metabolize them (break them down). Your body uses VLDLs to make intermediate-density lipoproteins (IDLs) and ultimately LDLs. These are important lipoproteins that your body needs. But, again, your body only needs so many. Excess LDLs in your blood can become trapped inside the walls of your arteries and promote plaque growth.
Research shows that the combination of high VLDLs and high LDLs is more dangerous than high levels of either of those alone. Plus, when your body breaks down VLDLs to make LDLs, some leftover bits remain. These “remnant particles” are made mostly of cholesterol. They’re small enough to get trapped inside your artery walls and promote atherosclerosis.
Atherosclerosis is dangerous because it narrows your arteries and raises your risk for various forms of cardiovascular disease, including:
Both LDL cholesterol and VLDL cholesterol contribute to plaque buildup in your arteries. One isn’t worse than the other, and they’re both equally atherogenic (meaning they promote atherosclerosis).
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Healthcare providers measure VLDL cholesterol through a type of blood test called a lipid panel. This test shows how much cholesterol is in your blood (total cholesterol). It also provides a breakdown of the different types of cholesterol (HDL, LDL and VLDL). It shows your level of triglycerides, too, which are another form of fat that travels on lipoproteins (especially VLDLs).
The lab that interprets your test results uses a math formula to calculate your VLDL based on your level of triglycerides. Your triglycerides are generally five times higher than your VLDL level. If you have a severe form of hypertriglyceridemia (high triglycerides), this formula may not be accurate. In that case, your provider will use other methods to measure your VLDL.
The normal range for VLDL is below 30 milligrams per deciliter (mg/dL). High VLDL cholesterol is 30 mg/dL or above.
High VLDL cholesterol raises your risk of cardiovascular disease. However, because VLDL is estimated through a math formula and not directly measured, your provider might not directly discuss VLDL with you. Also, VLDL isn’t the direct target of treatment. Instead, your provider will discuss your other numbers, such as your LDL level and triglycerides, as those are the targets for treatment.
Many people with high VLDL cholesterol also have one or more of the following:
You may be able to reduce all of these lipids in your blood by:
In some cases, an underlying medical condition can raise your triglycerides and, in turn, raise your VLDL cholesterol. Certain medications can also raise both. Talk to your provider about possible causes for your high VLDL cholesterol and what you can do in response.
A note from Cleveland Clinic
During your daily routine, you probably don’t spend too much time thinking about the lipoproteins that circulate in your blood. But if your healthcare provider told you that your cholesterol is high, you may start thinking about those particles and what they mean for your health.
The important thing to remember is not to panic. You can often manage high cholesterol with lifestyle changes and medication. Talk to your provider about what your VLDL number means for you and what you can do to improve it.
Last reviewed by a Cleveland Clinic medical professional on 12/05/2022.
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