My ldl is 191.am i at risk?do i need to take medicine?

Probably: Itr may be that sugar is your undoing. It was shown by dr yudkin, a professor in a major london hospital ("sweet and dangerous") in 1973 that sugar was the cause of heart disease. If your triglycerides are increased, that will prove that sugar is the villain.

High LDL.: That's a pretty substantial elevation of your LDL compared to our current LDL goals. It's not likely that you'd be able to lower your LDL to goal with diet and exercise alone - medications may be needed in addition to diet and exercise.