A 48-year-old woman from Mumbai with a 10-year history of type 2 diabetes (HbA1c 8.2%) and hypertension presents for cardiovascular risk assessment. She is on metformin and amlodipine. Lipid panel shows: total cholesterol 240 mg/dL, LDL 160 mg/dL, HDL 32 mg/dL, triglycerides 280 mg/dL. She has no clinical xanthomas. Genetic testing reveals a heterozygous mutation in the LDLR gene. What is the primary lipid abnormality driving her cardiovascular risk?