Hello DF5,   Your question is an excellent one.    First things first.  Your cholesterol numbers are not bad at all.  You are slightly above the target LDL of 130 (provided you do not have DM or some other risk factors for heart disease).  And you're HDL is TREMENDOUS!!  HDL should be HIGH.  The cardioprotective effects of high HDL are well documented.   Likely, your HDL is high because you are doing the RIGHT THINGS!  If you run 4-8 miles a day, I bet you eat very well too, including fish, fresh vegetables and fruits.  Doing these things can significantly raise you HDL.  However, there are some rare familial diseases that cause a high HDL, and at worst, your high HDL level becomes a neutral factor in your risk profile for heart disease.   There is not great evidence out there concerning your set of labs, both high HDL AND suboptimal LDL, specifically.  High HDL regardless of LDL is known to be cardioprotective (ie less likely to get heart disease), while high total cholesterol is known to be "bad" for your heart.  A few studies show that the ratio (with HDL to LDL ratio less than one being better) is more important than total levels.   Essentially, I think you likely have little to worry about from a cholesterol standpoint.  From our current understanding of cholesterol metabolism, your risk of heart disease from your lipid profile remains VERY LOW.   Of course, you should discuss these numbers with your doctors and continue to follow your lipid profile with them!   To your health, Neil MD