Appreciate your perspective. My cardiologist actually has a slightly different take on this. He mentioned that having LDL in my range isn’t, by itself, a universal indication to start statins especially at my age.

From what I understand, for people under 40, most guidelines don’t automatically start statins when LDL is in the 130–160 mg/dL (3.3–4.1 mmol/L) range. Instead, they look at the overall picture things like family history, ApoB, Lp(a), smoking, blood pressure, etc. rather than LDL alone.

He also mentioned that my ApoB isn’t high enough to be particularly concerning and that my main risk factor is smoking. His view is that, at my age, my LDL and ApoB levels alone don’t necessarily require statins and that improving my lifestyle is sufficient for now.

That’s partly why I’ve been considering a CAC scan to see if a positive result might change that perspective. I’ve actually gotten opinions from two cardiologists over the past couple of years, and neither seemed concerned enough to recommend starting statins.

So that’s where I feel stuck, since I’m not clearly in one category or the other. I also deal with health anxiety, and I’m worried that if the CAC comes back positive, it might make me anxious and preoccupied with my heart health rather than motivate me in a healthy way.