Hello! Thank you for asking on HCM! I read carefully your question and understand your concern. I would explain that the total cholesterol/HDL ratio is more indicative of cardiovascular disease than TC (total cholesterol). For men an acceptable ratio of TC/HDL is 4.5 or below, and women is 4.0 or below. Triglycerides contribute with 20% of the total cholesterol levels. That is why, when your triglycerides raise, your total cholesterol and this ratio raises too. There are many reasons (metabolic disorders), besides lifestyle for high triglycerides or cholesterol: - diabetes -kidney and liver dysfunction -thyroid gland dysfuction -some drugs ( anabolizants) I recommend performing the thyroid hormone levels, kidney and liver function tests, fasting glucose and blood electrolytes, to exclude other possible secondary causes of high triglycerides. I would advise starting therapy with statins or fibrates, as your ratio is above 4.5. You can continue this therapy as long as your triglycerides or cholesterol are high. But it it recommendable in elderly patients to continue a statin lifetime to prevent possible cardiac event or stroke, even when the cholesterol ratio is not very high. This is because their pleyotropic effects, in stabilizing the atherosclerotic plaques, thus preventing possible complications of these plaques. I recommend discussing with your attending physician on the above possibilities. Hope to have been of help! Best wishes, Dr. Iliri