My latest blood test report shows "VLDL" for the first time at 23.
According to what I read, it's normal range is rather wide.
This must be one of the non-HDL that we didn't used to check before.
Despite of a lot of exercise I put on to myself, it's tough to raise HDL.
While LDL is 91, HDL is 49.
Maybe, I should drink more? ㅎ, ㅎ, ㅎ.

Seriously I'd consider increasing the dose of statin you are taking if you do take statin,
or start taking  low dose of statin a few times a week if you are not taking statin.
As a general rule, it is advisable to keep non-HDL cholesterol below 100 mg/dl.
From the numbers I see above, yours would be 114.

Recent studies confirm that too much aerobic exercise such as running marathon
causes myocardial damage and arterial wall damage. MRI of the heart clearly demonstrated
the myocardial scarring. A good number of marathon runners have died while running.
One recent case report from my institution involved  a man who developed a cardiac arrest
due to ventricular fibrillation while driving. He was thoroughly studied and was found to have
normal coronary arteries but scarring of the myocardium which caused the arrhythmia.
Luckily this marathon runner was successfully resuscitated by the paramedics and underwent
the work up at our institution.
You are of course joking about alcohol.
Certainly that's not a option.
Come to my office, Michigan. I'll take good care of you.

Thank you for your invitation to your office but it's just too far away.
It will be really nice to have a family doctor who would pay close personal attention to my health.
Nowadays, as being a medicare patient, I seem to be just a number in doctor's office.
I've been on Simvastatin 20mg/day. I will increase to 40mg.
I used to be on Lipitor but my Medicare Plan D decided not to cover Lipitor, believe it or not.

Lipitor became a generic drug, Atorvastatin, a couple of months ago. It should be covered now.
I've been switching all my medicare patients' simavastatin to atorvastatin since without difficulty.
It would be OK to increase the simvastatin dose as you said for now, but find out if you could go back to
the generic Lipitor. The price of atorvastatin, they predict, will continue to go down in the next few months
as the complicated deals between the drug companies expire and a bunch of them start making it.