Hdl 30, triglycerides 291, ldl 196. do i need to do echo test? once a doctor told me there's chance for atherosclerosis.

No: More importantly, change your lifestyle at your age, walk briskly daily for 25 min to start and slowly increase, avoid all saturated fats; eat salmon, walnuts, avocado, so that your LDL comes down below 120 atleast, HDL increases to above 40 atleast, and TG will come down. Skim mild or 1% lowfat; no full fat milk; only whole grain breads (no white bread) in moderation that too. Recheck lipid 6 mo