High HDL and LDL at the same time is often present when total cholesterol is high. Total cholesterol includes free cholesterol in addition to lipoprotein cholesterol such as HDL and LDL. When total cholesterol is high, both HDL and LDL cholesterol may be high. HDL has an anti-atherosclerotic effect, it transports cholesterol from body tissues to the liver, which helps to reduce the risk of atherosclerosis; LDL accumulates the cholesterol it carries on the arterial wall, which tends to cause atherosclerosis. It is recommended that if dyslipidemia is present, prompt medical attention is recommended.