Aphex,
Go check your total lipid profile. 291 is pretty high but that with a low HDL/LDL ratio would not mean an increased risk of coronary heart disease (CHD) . What's also important is checking whether you have any other risk-factors for CHD such as heredity, smoking, hypertension.
I wouldn't be too worried but it's definately worth checking up. Just go to your primary care physician to get that total lipid profile including a general risk profile. If you have a high LDL diet and perhaps even lipid-lowering therapy should be considered.
/Matt