What role does HDL play in longevity?

HDL cholesterol has long been considered 'good' cholesterol due to its role in reverse cholesterol transport and its inverse association with cardiovascular disease in observational studies. However, recent large-scale Mendelian randomization studies and randomized trials (e.g., torcetrapib, dalcetrapib) have failed to show that raising HDL-C levels causally reduces cardiovascular events or extends lifespan. This suggests that HDL function—such as cholesterol efflux capacity, anti-inflammatory, and antioxidant properties—may be more important than HDL-C concentration alone. For longevity, HDL is part of a broader metabolic and inflammatory profile. Consumer DNA tests can identify variants in genes like CETP, LIPC, or APOA1, but these have small effects and are not predictive of individual longevity. Lifestyle factors (diet, exercise, sleep) have a much larger impact. Evidence is moderate: strong observational data but limited causal evidence from human trials. Safety note: no direct risk from testing, but misinterpretation may lead to false reassurance or unnecessary worry.