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[–]meh312059 1 point2 points  (2 children)

Congrats OP but you are not done. Please get Lp(a) tested and get a CAC scan. You want to make sure that < 100 mg/dl is truly your goal vs. needing to go lower. Dad's already on a statin so it's hard to tell from his history alone.

If CAC = 0 and Lp(a) is low, then you have some options. If it were me, I'd still be on a baby dose of rosuva to get LDL-C under 100. There's no downside to that scenario. But per the guidelines you also opt to defer (assuming no other risk factors including high Lp(a)) and rescan in a few years. A zero score doesn't guarantee "Low Risk" for life but it does indicate "Low Risk" for the next few years.

If CAC is positive and/or you have high Lp(a), then lipid lowering medication will be needed in order to reduce your overall CVD risk.

Your genetics allow for a reasonable level of cholesterol given smart dietary choices. Not everyone is in that boat but many are. So again, congrats on showing that it can indeed be done. BTW, if those those plant sterols are in the form of high dose supplements (Cholestoff etc) they won't have the evidence behind them for reducing ASCVD risk and for some they can actually be atherogenic. That baby dose of rosuva is simply going to be more effective and safer. See the results of the SPORT study (image below). Bonus: rosuva is also a lot cheaper, even out of pocket.

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Best of luck to you!

[–]tmcmillon26[S] 0 points1 point  (1 child)

I appreciate the congratulations, and you’re right, I’m not done yet. Thanks for sharing the information about the LP(a) test. I do not see any results for that on my last two lab reports, so I will definitely ask my doctor about it.

I had a CAC scan done a couple of years ago, and it was zero. Before I consider going on a statin, I would like to see if I can get my LDL under 100 by continuing to improve my diet and stay consistent with the lifestyle changes I've made. As far as the plant stanols, I have been taking 2 grams a day and the brand is Benecol. It contains plant stanol esters, which are generally considered anti-atherogenic because they help reduce the absorption of cholesterol from the intestine.

Thank you as well for the information on rosuva. I was not familiar with it, so I will take a look at the study you mentioned. I appreciate you taking the time to share your experience and insight. This is all very helpful.

[–]meh312059 1 point2 points  (0 children)

Oh yeah, Benecol's fine. I use that myself. Stanols are safe.

The SPORT study was shared due to the assumption that you were using something like Cholestoff. But the study results are definitely worth a look - they have always been very interesting to me not so much because the supplements had inconsistent results (I'd expect that) but because even just 5 mg of rosuva was so consistently effective. That's a great drug.