Cut out sauturated fat which raises your LDL. HDL is not an important number, total LDL is the best and most accurate predictor of cardiovascular disease that we have. ApoB and Apo(a) are also good tests to get, they are a bit newer and we dont really have meds to treat but they are also accurate in predicting cardiovascular risk.
You are in the 80th percentile according to the MESA percentiles for LDL cholesterol, you should aim to be in the 20th percentile or below, LDL 93 or lower. LDL builds up in your arteries and greatly increases your risk of stroke and heart attack. Statins can cut that in half easily. A lot of people report side effects like muscle pain and misinformation about "cognitive issues" however when people were given pills that looked the same but contained no medication, they reported the same side effects.
Do not bother with natural supplements, red yeast rice is commonly mentioned since it is where the first statin called lovastatin was isolated. Since it became a medication, manufactuers are required by law to take the lovastatin out of the red yeast rice. If natural supplements were effective, they would have become medications already. Rosuvastatin is commonly said to have the least side effects because it mostly stays in the blood instead of going into tissues, but generally statins are side effect free and help prevent heart attack, stroke, coronary artery disease, and stabilising or even slightly regressing existing plaques.
HDL is said to remove plaque from the arteries but trials showed that raising HDL did not improve cardiovascular outcomes (niacin for example raises HDL, in addition to causing liver damage in some people). If you are still worried about it statins themselves modestly raise HDL.
