Or a coronary ct to see what degree of atherosclerosis you have.

But if you were my patient I would need to know lp(a), apoB, a1c and other risk factors, cardiorespiratory fitness levels, etc too to determine how hard to push it (as most are opposed to meds) though imaging would be the main determinant.

If it were me in this day and age I would drive that down now but depends where you are now and what you prefer. In general how aggressive to get with primary prevention is debatable. But if you have the ability to crush the disease process that is most likely thing to kill you in your lifetime, then I would effort on the side of being aggressive (with any form of insulin resistance as well). Ironically that message resonates a little more with the younger generations these days.