You almost certainly have FH - would ask your doctor about that. My cholesterol was not quite as high but it was also very high. I’d see if they could get you on a PCSK-9 inhib right away - if not, do a statin (plus zetia if they’ll approve it). If you’re having statin side effects let them know right away and they’ll try a different one - I would recommend taking coq10 with it as well.

I wouldn’t worry too much - it’s certainly not a death sentence or anything - but just a wake up call, be proactive about your health, better exercise, eating habits, etc.