I'm not a doctor, but with total cholesterol over 200 and LDL at 141, my understanding is that you are at high risk. You should be looking at total cholesterol in the 150 range and LDL, for the "normal" population at under 100; I would think based on other risk factors yours should be under 70. If you are at a higher risk, then LDL needs to be under 50. Even if you moved to a perfect diet, weight, and exercise, you're not going to get those numbers without drugs. Takes me 3 (statin, etezimibe, repatha) to get there. Also, as noted above, the high sensitive c-reactive protein test is another good place for your doctor to assess risk.

The Repatha injection seems to be lowering Lp(a) for me and others here, but it's not the primary use. For me, it lowered my LDL from 109 to 27 and total cholesterol from 175 to 87.