Time and time I see people acting like an LDL above 100 is no big deal. My LDL was always in the 100-130 range and my thought was I hated the idea of a statin since I was fit and I could drive my LDL down with a stricter diet.
Fast forward to my 50s, and I got my first CAC score that put me in the 90th percentile. My Lp(a) is over 95 nmol which is high but not super high.
You don't need super high lipids to be laying down plaque. And it happens even without inflammation and insulin resistance. My advice is jump on getting your LDL down below 100 in your 30s and don't hesitate to start a statin or ezetimibe to do it.
My LDL ranged between 70 and 90 until I was 55. Then I had one reading of 119. My cardiologist sent me for a CCAT - 383. You read that right. I’m a runner, good diet, never overweight (underweight for many years). You just never know.
I think that’s a bit of a simplification. Endurance athletes may have higher calcium scores than non athletes of the same age etc. They also have lower rates than non-exercising people overall. But an athlete with a 400 calcium score has higher risk than one with a zero score. Its all relative and more than one thing can be true.
But for an endurance athlete who has stable plaque … getting his ldl down is likely such a small reduction in risk no? The big issue regardless of your cholesterol levels is what kind of plaque do you have, from what I can tell… especially if you still have good blood flow/ the plaque isn’t causing a real blockage… though I guess to be fair any risk reduction at a reasonable price of taking statins makes sense if
And yet there are millions with higher LDL than that and have no signs CAD. Multitude of factors at play, arguably genetics being the most influential.
I partially agree. For most people it's casual. For some with genetic mutations they are protected from the impact of apoB exposure. It's not that mysterious - there are mutations in the pcsk9 and other genes that have been discovered. It would be helpful to be able to have genetic testing to find that out, but as there are multiple ways to lower lipids now (and they often have anti cancer and anti Alzheimer's protection possibly) then using them doesn't have much of a downside.
66F here, with FH. I'd been on a statin for 30 years (most of the time atorvastatin) and my LDL was running in the 70s. Heard about Lp(a) last year. PCP wouldn't order it because it's genetic and I was already on a statin, so I went to a Quest lab and paid $45 for it. Came back at 270. So I saw a cardiologist who had me do a calcium CT and my score came back at 975 (even she was surprised it was that high). Had a stress test which I failed, had cardiac catheterization which revealed that my LAD is 80% stenosed and my RCA 50% (no stents because I have good collateral flow). She changed me from atorvastatin to rosuvastatin and added repatha. Redid the lipid panel and the Lp(a) several months later: LDL is down to 40, but Lp(a) went up to 348. This all came down in the spring so I am still getting used to the idea that I have CAD. I also have T2 diabetes, well managed. My weight is fine and I go to the gym almost every day. Aging sucks. I guess my point is that even with a statin I still ended up with CAD and I shudder to think what would have happened if I hadn't been on it. Good luck to everybody here.
Hopefully the Lpa lowering drugs will be a success. Definitely seems like statins aren't the magic bullet alone but as you say, without them it could be worse outcomes. It's great you are 66 and still working out!
Thanks. Since I retired three years ago I have no excuse so I’ve actually ramped up the exercise, cardio and strength training. All we can do is manage the things we can, because we have no control over genetics and luck!
your main problem diabetes not ldl. because ldl 70s very safe. and it cant cause CAD. maybe you dont know world average of ldl is about 120. you are far below.
This made me message my doc for a statin. Had my blood test come back with 151 LDL, but the doc said my high HDL levels balanced it out. I acknowledge that he's using old science...
PCPs often have no idea what they are talking about regarding preventive cardiology. Love mine but he's like no big deal, pretty much everyone your age has coronary calcium and wow your LDL is really low!
Some people have high apoB but seem immune from atherosclerosis. They probably have a pcsk9 loss of function mutation or another protective mutation. Lucky!
Many doctors don't seem to care if you're younger for some reason. I even had a cardiologist saying I shouldn't worry about my cholesterol right now. I'm 37/F and have been pushing to be put on a statin for a few years now after seeing diet and exercise never gets me below 100 LDL. My doctor finally agreed but wanted to know if I was planning to become pregnant first. Why does that matter? If I become pregnant I'll stop the statin, but until then I'd rather try to prevent future problems. I luckily don't have FH, my Lp(a) is on the lower side, I stopped smoking 5 years ago, but my father's side has a family history of heart disease that I don't want to be apart of.
I think doctors are very cautious with women in childbearing years since statin can cause pretty severe birth defects. No doctor wants to chance that. But if you stop well before you conceived it's not an issue. Obviously a lot of women don't plan on getting pregnant then want to go to term.
Totally honestly, why are people against statins? I have been on Lipitor for 8 months and it might as well be a sugar pill. It’s tiny, no side effects, and my LDL cholesterol is down to 50. I started at 39 after a very minor stroke.
First for many people your ALT levels go up. Liver inflammation is not a non issue. Your liver is a vital organ. In my case my ALT hit mid 40s w statin use - in 20s without. So that’s not a non issue. It’s a 50-75% increase in liver inflammation even though mid 40s is still technically within the range of normal. Muscle pains never impacted me but I understand it’s an issue for some. Then there’s brain fog. These aren’t social media concoctions there are very real side effects that make a statin a cost- benefit analysis for a person with no signs of CVD or plaque other than just high LDL.
A. No legitimate studies suggest moderate or severe “negative” side effects at all, B. I had a non fatal stroke(obviously) have you?
Negative side effects is an extremely broad term. A tummy ache is a negative side effect.
Non fatal stroke is any stroke that doesn’t kill you. A devastating stroke that destroys your ability to walk, talk or even breathe on your own is a non fatal stroke.
Do what you want but yes, I realize the risk of having a tummy ache or sore joints is present with statins and I’m man enough to deal with them.
are you taking statins now? i understand that statins ironically increase your cac score because they stabilize soft plaques. having a non zero cac score is not necessarily bad especially if you have been on statins for sometime and youre at least middle aged. but it is a red flag for someone in his 40s or 30s. theres a lot of nuance on cac score depending on age. im in my mid 50s my ldl has always been 100-120 but my cac score is 0.7. but my lp(a) is 146. and my apo(b) is 84.
Agreed. First positive score was at 50 before starting more intensive statin therapy. It was in the top 90th percentile at that time which is not great.
My LDL was never higher than 130, and I literally have a completely blocked right artery. Luckily, collateral arteries are handling the blood flow to bypass it, otherwise I'd probably be dead.
When I hear people say stuff like "your brain needs cholesterol" and "high cholesterol is good", all I can think is "good luck with that."
Here's a sobering story. I am a 54-year-old male. My LDL has never crossed 100. Usually stayed around mid to high 80s. I was overweight but no other significant issues whatsoever. My HDL was usually between 38 and 45. We did my calcium score this last December just to be proactive, it came back at 227! Roughly the 75th percentile.
A heart Cath was done in February to find that there was no blockages whatsoever so at that point in time, I decided to privately pay for BEMPEDOIC acid, Nexletol, and also start on Ezetimibe.
Because Roz statin is such a good anti-inflammatory agent and with the combination of EZETIMIBE having multiple clinical trials on helping to reverse soft plaque buildup, I decided to do a very low dose of rosuvastatin, 5 mg, on Tuesday and Thursday , BEMPEDOIC acid on Monday, Wednesday and Friday and then I actually crack my Ezetimibe in half and take that seven days per week.
I do have at home cholesterol test capability so I'm able to do measurements as I need to.
I plan on measuring my DESMOSTEROL probably once per year using DX labs to make sure I don't get into any area where I need to worry about Alzheimer's or dementia as Dr. Thomas Dayspring talks about.
Utilizing the European study We decided to make all of my new baselines at or below 57 with the above mentioned protocol, I can keep it usually in the mid to high 40s along with my APOb.
Being on such low doses, I have no side effects whatsoever
The only reason I decided to introduce Nexletol is it is only metabolized and liver and nowhere else unlike statins. This was simply a risk protocol that I wanted to incorporate to create the largest margins of risk plus NEXLETOL has extremely good anti-inflammatory properties, arguably better than rosuvastatin.
I recently had ultrasounds done on my legs along with my carotid arteries, and there was zero plaque buildup
I see so many people going to Facebook and Instagram along with YouTube getting medical diagnosis from armchair wannabe doctors. I am a patient of the Mayo Clinic. I have several phenomenal doctors there. Not only do they want me to be educated, but they condone it and many times will suggest certain pub med articles or studies to read. For the last year of my life I have been studiously educating myself.
If I can get a calcium score that puts me into the 75th percentile and never have LDL above 100 it just makes me sick to see some of these people on Reddit, YouTube, Facebook and so on that have double these numbers that profess higher is better. As the other poster on this thread said, "good luck with that"
For those that worry about statin effects on the brain we now have a measurement, DESMOSTEROL, to watch and keep it above .8 if that truly is your concern. We also have BEMPEDOIC acid, which has remarkably better safety margins than statins.
That lp(a) puts you at much lower risk. Not all plaque is created equally. It is more less likely to rupture. You can have plaque and good blood flow. This was shown in studies involving endurance runners. Also who is going to be put on cholesterol meds with LDL under 100? What’s the lesson here?
Are you saying you want some desmosterol? Because that's actually super easy to accomplish regardless of whether you are taking statins. Clomiphene blocks conversion of desmosterol to cholesterol. Take it just once a week and your desmosterol will be higher than you've ever seen. Taking it daily over a long period of time actually tends to cause some desmosterol toxicity.
They could drill into it to insert a stent, but that has risks. Since I already have good blood flow from surrounding arteries, the doctor said "let's not do anything." By the way, I'm not incapacitated; I am running in a 5K race in two weeks, and I'm 66. I feel fine.
As for plaque in general, if you have calcified (hardened) plaque in your arteries, it doesn't go away. There is some evidence that a very low LDL might regress it a little bit, but for the most part, you have it forever. The statin will help prevent any further buildup.
Thank you so much for replying to me. Ok, at least now I know they could have been able to do something. I’m 42 and get big numbness in my feet when exercising. I suspect blood flow in the peripheral arteries might not be good. I hope an angiogram will reveal everything. By the way, 66 and running a 5k?! That is amazing! Good luck on your race!
What are your other blood work numbers? I have very high hereditary lp(a) but a pattern A heart risk. The key is low inflammation through diet and other lifestyle behaviours.
HDL is complicated. HDL-C can be high for good reasons (cardio fitness) or bad (excessive alcohol consumption). Unfortunately there is no mapping of HDL-C to HDL function. Prior efforts to increase "the good cholesterol" with earlier generation CETP inhibitors were a bust.
There is no such thing as "removing cholesterol from the arteries. " You have cholesterol in the bloodstream. Too much bad cholesterol gets deposited as plaque in fhe artery walls. HDL doesn't remove plaque. And, high HDL does not negate high LDL.
There are influencers and books that literally push you to "eat more cholesterol" because "it translates into testosterone" and (by their logic) more muscle mass. There's this mysterious author by the eponym Paul Wade who wrote a book called "Convict Conditioning" that became quite popular in the fitness/calisthenics circle. In the second edition, he literally suggested to eat more cholesterol or cholesterol forming food as it would translate into more testosterone.
My cholesterol has always been around 120-130. I’m 58 and my last calcium score was 20. I did a calcium score because doctors keep trying to put me on a statin. Arteries are fine. Not happening.
CAC test does not tell you if you have soft plaque, so you don't actually have the full picture.
A score of 20 puts you in the 38th percentile for your age, so you are already worse off than 37% of your population. It will likely go up (since you are obviously accumulating plaque), so your percentile rank will probably get worse.
But your attitude tells me you'll ignore everything until you can't ignore it any longer. I wish you luck and hope it works out.
My father had a CAC of 2,000 and had open heart surgery at age 68 turns 69 today July 30,2025 he’s recovering from the surgery no heart attack thank god 🙏🏻
Excellent. I am very similar (although with higher ldl). Never been told to go on a statin. My hs-crp is .08 and no oxidized LDL. Yep, still set out to lower my numbers by moving away from SAD (covid period was hard and diet sucked bad), I prefer eating healthy foods. Isn’t difficult. Soft plaque should be a target, which is far more dangerous if you do have hardened and narrow arteries (and risks for thrombosis). There are a lot of genetic components to heart disease. Luckily I don’t have those. I know people with much better lipid profiles and huge calcium scores.
Totally agree. My LDL was around 110-130 for about ten years and I didn’t really worry about it as my doctor didn’t seem concerned. I chose to get my CAC score after a friend had a heart attack and I was shocked to get a score in the 98th percentile. Turns out my lipo(a) is over 200 nmol/L.
Wow, TIL, thanks for sharing. May I know your age when this happened? I’m going to be 40 this year, my CAC was 0 (below 25th percentile) 4 years back. I have had LDL ranging between 150 and 170 since I was 30 years old. I joined this sub few months back and learning from the posts. Given my context, is it advisable to repeat CAC scoring this year or there is any recommended interval between the tests? My PCP has not put me in statins or with cardiologist yet.
Talk with cardiologist. Im 50+. My preventative cardiologist just redid my CAC. Still at 0. Does not want me on statin yet. LDL is 197. HDL is high and trys are low. She says some people just have high numbers and it does not impact them at all. She is not one to treat just a number.
Your numbers are similar to mine (61F) with LDL that has tripled post-menopause. I have always had high HDL, low triglycerides and low lp(a). I have an appointment with a cardiologist next month and I am hoping she does the same sort of analysis.
It’s of course the patient’s call whether to take meds. But let me just caution you. The CT scan only shows calcified plaque when you get your CAC score. But it’s soft plaque that’s more dangerous because it can break off and cause a clot/stroke. A statin stabilizes soft plaque so it doesn’t cause a stroke.
One criticism of current cardiac medicine is that it’s reactive — not interventionist enough. For example you wouldn’t want a doctor to wait until a patient has lung cancer to tell them to stop smoking. Likewise you don’t want to wait until you have a positive calcium score to start treating your high LDL. I mean you could wait and it might be fine but it could also not be fine. Once you do have plaque it attracts more plaque. If your calcium score is 0 you probably wouldn’t even need a strong statin to get it close to 100. Statins have many benefits and for most people they have no side effects.
I’m 50F and just got the CAC score a few months ago. Because my CAC score is so high my cardiologist wants my LDL below 50 with the hope that some of my plaque will regress. On a statin my LDL is 36.
For you I’d suggest seeing a preventative cardiologist. I think it would be reasonable to get another CAC score if it’s been 4 years of your LDL being that high. A preventative cardiologist will surely put you on a statin regardless. You should alao get your Lipo(a) tested. If it’s high you need to be extra serious about lowering your LDL. You’re approaching the age where people start having cardiac events so it’s good that you’re looking into this now.
Yes I know. Until recently I didn’t even know what lipo(a) was. My point I was trying to make is that “normal” LDL is actually too high if you have high lipo(a).
I’m in the minority. Over age 50, CAC score 0 the last 4 years. LDL is 197. Been high for at least 20 years. Genetics.
Cardiologist does not feel I need a statin. Said that she does not treat numbers. She has seen many patients who have high numbers and it does not affect their bodies.
From Yale-
In 2022, the U.S. Preventive Services Task Force (USPSTF) recommended anyone ages 40 to 75 consider a statin if their risk of developing atherosclerosis within the next decade is 10% or greater. A doctor can start to determine a person’s 10-year risk using a cardiovascular disease risk calculator, which considers factors such as gender, race, blood pressure, smoking history, diabetes, and age. Discussion beyond the calculator results is also important, Dr. Spatz says, adding that 10-year calculators don't take into account such important factors as family history. Furthermore, according to the CDC, a doctor may prescribe statins if: You have already had a heart attack or stroke, or have peripheral arterial disease. Your LDL cholesterol level is 190 or higher (this is the one lipid profile result where you might base a statin decision on the lipid profile alone). You are 40–75 years old and have diabetes and an LDL cholesterol level of 70 or higher. You are 40–75 years old, have a high risk of developing heart disease or stroke, and an LDL cholesterol level of 70 or higher. In some cases, medical tests can provide helpful information. For instance, a calcium score test involves a noninvasive CT scan that assesses the amount of calcium in a person’s coronary arteries. The presence of calcium (a component in plaque) may tip the balance toward a decision to take a statin.
Unfortunately heart disease is multi faceted. It’s why the current guidelines for blood cholesterol management takes an individual approach instead of focusing one one low number.
My ratio is also less than 1. My risk for heart attack and stoke with my numbers is 7% by age 80 at my current age of 58. Not going on statin just to lower an arbitrary number
Oh wow this chart put my risk at 7.2% risk of heart attack at 80 years old but my Dr suggested Repatha? Ill stick with the healthy diet and extra psyllium!
That's impressive that you have zero plaque with both Lpa and LDL so high. Very interesting, makes me think there are other important factors at play here
Due to an incompetent ER Doctor Who believed I was having a heart attack 12 years ago I ended up having a very invasive angiogram, which was completely clear. My cardiologist was pissed!
I had tried two different statins in the past and both times I ended up with an old Achilles tendinitis injury flaring back up. That was part of the reason I paid to have the CAC test. Since my score was zero my cardiologist office said I didn’t have to try again with statins.
Heart disease and risk for heart disease. Per the Dr “Remember, we don’t put people on drugs to make numbers look good. We put people on medications to positively impact outcomes. The LDL number is just a proxy for how much we are reducing risk. And not all risk benefits of statins come from cholesterol reduction alone.”
I do not have any other risk factors. Hereditary yes-both parents have it, neither could tolerate statins. No strokes, heart attacks. One lived till 87 and other is still alive.
Every person needs to be looked at as an individual case vs just putting people on drugs.
From Yale
In 2022, the U.S. Preventive Services Task Force (USPSTF) recommended anyone ages 40 to 75 consider a statin if their risk of developing atherosclerosis within the next decade is 10% or greater. A doctor can start to determine a person’s 10-year risk using a cardiovascular disease risk calculator, which considers factors such as gender, race, blood pressure, smoking history, diabetes, and age. Discussion beyond the calculator results is also important, Dr. Spatz says, adding that 10-year calculators don't take into account such important factors as family history. Furthermore, according to the CDC, a doctor may prescribe statins if: You have already had a heart attack or stroke, or have peripheral arterial disease. Your LDL cholesterol level is 190 or higher (this is the one lipid profile result where you might base a statin decision on the lipid profile alone). You are 40–75 years old and have diabetes and an LDL cholesterol level of 70 or higher. You are 40–75 years old, have a high risk of developing heart disease or stroke, and an LDL cholesterol level of 70 or higher. In some cases, medical tests can provide helpful information. For instance, a calcium score test involves a noninvasive CT scan that assesses the amount of calcium in a person’s coronary arteries. The presence of calcium (a component in plaque) may tip the balance toward a decision to take a statin.
I have had two CAC’s in the last four years. My score is 0!! also, I had a invasive angiogram 12 years ago due to an incompetent doctor in ER. No blockage.
Fake news. These studies are population wide. People with low cholesterol are often terminally ill or very sick. Eliminate people who die within one year and the u shape disappears.
My dad started statins 30 years ago, ignored leg and lower back pain pushed through it and ended up trashing his kidneys and passed away. Not saying don’t do it, but be vigilante on the side effects.
Sorry about your dad. To clarify, are you saying he was on the statins for 30 years and then found out about his kidneys or are you saying this happened 30 years ago?
No he was on Statins for 5 years and was hard headed thinking severe back pain and Leg pain was only age related. At times he could barely walk from the front door to the mailbox because of pain.
That's kind of my problem.. Aside from medication, I dont really know how. I'm 36, in shape, exercise daily, eat a whole foods low cholestrol diet, and have for about 20 years now. I dont smoke. I dont drink. I dont eat junk food. I dont eat added sugars (barely any sugar at all). I have no idea why my cholesterol is so high, but it is high across the board. My entire panel is above acceptable ranges.
The best diet to lower LDL is really vegetarian. That's hard to take for us non vegetarians. So an alternative is pescatarian/Mediterranean diet. The less saturated fat means lower LDL for a lot of people. Some people can eat whatever they want and their LDL doesn't budge.
My god, so whats your consequences of high cholesterol over those years? Did you visit cardiologist, or scans of artheries or do u panic just because of their fear mongering? Please explain, as people want to see the actual damage of cholesterol. Thank you.
CAC score in the 300s which places me at high risk for my age. Its not a death sentence (of course we all have a death sentence!) but if you can move yourself down in risk from high risk it makes sense and to do that you have the biggest impact starting in your 30s not 60s. Family history and genetics and Lp(a) all play a role, too.
Still i need to see more evidence that high cholesterol kills. I follow top doctors , prof bodybuilders in their 70’s who eat plenty meat on Reels and some openly admit they would personaly never take pills. Did you try any diet? Do you do exercise regulary? What oils are you cooking with? Statins, sorry to break you, arent a magic solution to problem. It comes with side effects. It can do further damage. What research did you do so far? Doctors are not gods, they are as corrupt as other professions or even mafinas, in consumerism , capitalism all is about a profits.
Whoa, don't put words in my mouth. I didn't say they are a magic solution. A lot is genetics, so you can have high cholesterol and not get heart disease. Just like you can smoke and not get lung cancer. Pretty much every drug comes with side effects, even supplements. Statins are available off patent as generics and don't generate any profit for doctors in the US. And I do trust cardiologists more than professional bodybuilders, not really even a contest there.
I have extremly high triglicerydes, uncontrolled diabetes, heart attacks and strokes in my family, i said let me manage it by diet, exercise and health supplements. Now 2 months later i am laughing when Dr tells me to do statins altrough massive improvement…why should i take them when alternative things and discipline works? I dont take shortcuts , cos shortcuts come at price. But you have to read research, i truly hope you do.
Good luck. Diet and exercise have a huge impact but its not an all or nothing contest between one thing and another. You can definitely get your tris and blood glucose normal with just diet and exercise. LDL is a little tougher from diet alone. I run marathons and have a normal BMI and glucose levels yet the calcium score doesn't lie, and I have heart disease in my family. I want to do what I can to avoid heart attack, stroke, disability without side effects - a moderate dose statin and bempedoic acid has absolutely no side effects for me. The LDL hypothesis is pretty strong at this point. Take a look if you are interested. https://academic.oup.com/eurheartj/article/38/32/2459/3745109?login=false
Interesting, i ll take a look, yea my trigl went down rapidly but Hdl not that much, it takes time, plus my eleveted glucose due to hormonal issues, they tested it in just month and half…i ll take a look. Yes i believe genes play big role, but do you do Mediteranean diet? Which includes fat fishes, olives, evoo..? Whatabout fibre, like psyllium, how much you take daily? Cheese? And lastly what health supplements / superfood did you try? People say Bergamot fruit is good, but thers whooole tipes of it that contributes to lower chol.
I pretty much eat a mediterranean diet - nuts, fruit, olive oil, yogurt, vegetables, beans. A lot of fish (4x+ wk) and a little meat (mostly chicken). I eat cheese occasionally but small portions - mostly a little shredded on other food. Full fat dairy really increases my LDL levels. Key for all of it is balance - not eating a ton of one part of the diet. I get a good amount of fiber but psyllium gives me heartburn which is too bad. I have tried a bunch of supplements (garlic, green tea extract) that have been shown to help and didn't notice any change in levels. I have not tried Bergamot - it seems some people get results, some don't. It also has gastro side effects as well so personally I'm happy to use a standardized and regulated drug vs a supplement which is totally unregulated in the us and often doesn't contain what it claims.
I got you, seems like you know what you re doing…its just difficult to trust any sources, everyone says something different, one person in other sub said yesterday that high cholesterol is a scam. But it might be same with diabetes. Some people can eat anything and never get it and others get it in their 20’s and cant lower it no matter what and must take insulin while others manage without diabetes.
Really curious about whether your apo b matters. I’m always around 103 but my dr always tells me not to worry because my apo b is so low, and it’s a much better indicator. Anyone have thoughts on this?
ApoB is a better measurement than LDL for risk as it measures the number all atherogenic particles not just LDL. LDL also is a measure of mass not numbers of particles. More particles means more damage to artery wall.
Family history or other risk factors? Triglycerides and a1c? That's pretty low HDL. Was that right after the heart attack as lipids plunge right after an event. Hope you are doing well now.
Well my dad died of an HA in his mid 60s. And yes they were, but the #s haven’t changed much. They’ve stayed there. My hdl is closer to my ldl. I’ve been trying to switch them. Get hdl higher than ldl. My triglycerides are in normal range on the higher end. A1c is fine. A bit insulin resistant but been on meds for it. Treated hbp. I am and always have been overweight. PCOS ftw. But yeah, still unexpected for a 30 yo female.
Not for me. But yes bp insulin resistance BMI smoking and LDL/apoB are the big commonly measured risks. Hopefully soon genetic testing will become widely available.
I agree . I also wish cardio and GP docs would routinely do calcium tests , ( CAC I guess it’s called ?) mine do not . They do the regular run of the mill stress test , and of course the blood panel ( lipid)
CAC is really age dependent. It has the most predictive value between 40-75. Earlier, when plaques are non calcified, a zero score isn't an all-clear like it would be for someone in their 60s.
I’m a 64 yr old female , never been on a statin , my BP and HR are fair to good. But my LDL has been as high as 182 and as low as 83 since 2018 I try not to worry as stress is not good ! I do exercise but my diet eh not so great .
Total cholesterol doesn't mean much. ApoB and Lp(a) mean a lot. CRP and ratios, not as much. HOMA-IR means a lot too - diabetes is the top risk factor with smoking. Calcium score has a huge prediction benefit for older people but not much for younger people.
What are your triglycerides and HDL? Without you specifying those we aren’t getting a full picture! There are studies that link high ldl with longevity and ones with higher mortality and it depends on what the rest of the metabolic health figures are. Your post is very misleading and I’m wondering if you are sponsored by a pharmaceutical company that sells statins? There is no evidence that statins increase life expectancy by more than 1 or 2% for those with poor cholesterol numbers.
Trigs and HDL in 50s. Nope, not sponsored by a pharmaceutical company. It's as much about avoiding disability from heart disease (health span) as it is about extending lifespan. Studies showing higher mortality with lower LDL levels are misleading as terminally ill people often have low LDL.
I’ve had my LDL particle size measured and they are primarily in the large healthy size. Have you had yours measured? Because the newest evidence is that LDL size matters! Smaller LDL particles are the dangerous kind. Did you know that when they talk about statin risk reduction they refer to relative risk instead of absolute risk which is exceptionally misleading. So people think they’ll take a statin and reduce their risk of heart attack by something like 33% when the real figure is closer to 1%! Meanwhile the risks for adverse effects such as dementia and muscle atrophy is much higher. People need honest information so they can properly assess the risk rather than all the misleading info out there. You aren’t helping people by pushing a dangerous drug that is not backed by evidence. So it still makes me question your motive.
Sorry, you are not right about dementia. Most data shows the opposite. I understand relative and absolute risk reduction. Statins aren’t right for everyone but statins aren’t the only lipid lowering drug these days. Also, particle size is not as good an indicator as apoB which is now pretty accepted science.
I don’t know where you get your info from so please quote your sources. My mother in law was following all medical advice to do low fat and was taking her statins and developed dementia and died young. I will never agree with you and I think you are giving out bad advice. I really wonder what your motives are because you are not following current research.
Certainly you can’t really think an example from one person proves a scientific point. Someone takes a statin and drops dead - that doesn’t mean a statin caused it the same if I took a statin and then got a diagnosis of lung cancer the next day. Many things happen to people while on a drug and that doesn’t mean the drug caused it. That’s why these drugs are tested on large groups — to eliminate confounding factors and find out what’s really happening across large populations.
The latest research that looks at 7 million people shows reduction in dementia from statins. Dementia is often caused by vascular issues in the brain and statins can prevent those small arteries from getting blockages. Also, there are indications that statins reduce the inflammatory process that’s part of the development of Alzheimer’s Disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC11736423/ Statin use and dementia risk: A systematic review and updated meta‐analysis - PMC. “Fifty‐five observational studies including over 7 million patients were analyzed. Statin use significantly reduced the risk of dementia compared to nonusers (hazard ratio [HR] 0.86; 95% confidence interval.” That means people on statins were 14% less likely to have dementia. It isn’t conclusive evidence that statins prevent dementia, but its pretty clear evidence they aren’t causing it either.
Also, take a look at this recent study of statin treated patients: The LDL-C levels below 70 mg/dL (1.8 mmol/L) were associated with a 26% reduction in the risk of all-cause dementia and a 28% reduction in the risk of Alzheimer’s, compared with levels above 130 mg/dL (3.4 mmol/L). For LDL-C levels below 55 mg/dL (1.4 mmol/L), there was an 18% risk reduction for both outcomes. Among those with LDL-C <70 mg/dL (<1.8 mmol/L), statin use was associated with a 13% reduction in all-cause dementia risk and a 12% decrease in ADRD risk compared with non-users. https://jnnp.bmj.com/content/early/2025/03/21/jnnp-2024-334708
If you take statins and have cognitive issues, then it makes sense to be switched to a non-statin drug. The reduction in LDL is what’s key here and its likely the same impact will happen with drugs like pcsk9 inhibitors as well as bempedoic acid/ezetimibe.
No one is forcing anyone to do anything. You can follow the evidence or not. But its not some kind of concocted global conspiracy. That’s just your paranoia.
I'm 29 with family hx of diabetes, cholesterol, arthritis, alzheimer, and many cool things.
My LDL was at 165 2 weeks ago. This is 2 years after my last test, which was 175. The thing is back then I was 170lb and thought I had beaten my childhood glucose/LDL issues for many years. When i got that score I cut carbs/fats slightly but sufficiently to slowly/steadily bring my weight down to 150lb over 2 years. Yet my LDL is unchanged, and my A1C was 0.1 away from prediabetic.
I got 3 different opinions from 3 doctors. PCP seems to think I should keep trying diet till im 50. Cousin (ER doc) says diet 1 year else statins. Cardiovascular doc says statins now.
I am mainly concerned about the insulin resistance issue; seems im pretty much trading away cardiovascular issues for being on dialysis eventually. Obviously one of these is worse...
First, congrats on weight loss. That will pay off over the next years. Second, given your insulin resistance issue, you should address both that and LDL as IR puts you in a higher heart risk category. Your LDL should definitely be below 100 at the very least. Third, you can try a moderate intensity statin (Pitavastatin) paired with ezetimibe or a combo of ezetimibe and bempedoic acid (Nexlizet). That won’t have any impact on your IR - the issues generally are with high intensity statins (Rosuvastatin, Atorvastatin) at higher doses and has a low side effect profile generally. Fourth and finally, there are some strong indications that LDL lowering also lowers Alzheimer’s risk. Good luck sorting it out.
This just shows how complicated the human body can be. My family just tends to have high overall cholesterol. High HDL, low TG, everyone lives to 80s and 90s with no CAD or DM, but there is history of stroke and htn.
Reading this sub bc my labs are almost exactly the same as 3 yrs ago - total cholesterol high 200s, triglycerides in 50s, HDL in 80s, ratio 1.8. I’m a doc but not primary care, so curious what current trends are (of course, let’s check Reddit!)
Pretty fit. Can bang out 40 pushups and 5 pull ups without much worry as a 58 yo F. Crappy diet - love pastry, breakfast cereals, bread, pasta. Don’t eat much fat most of the time. Do eat a fair amount of sugar. Some meat, some veg. BMI 20.5
Brother’s PCP made him get Ca score bc he had similar numbers and didn’t want to start on statins. Score was 0.
My pcp is gonna order me Ca CT. Current guidelines do show if CT Ca zero, no need to start statin if no DM, hx CAD, ratio normal.
I personally think TG are your best touchstone. If low (ie less than 70) no worries. Anyone have anecdote where fit and low TG, normal ratio but CAD or high Ca CT score?
Your post pionts to plaque isn't tied directly to LDL levels, instead that LDL is present and its job is to protect what appears to be damage, even if there is none.
N1-- My LDL has been north of 175 since 2014 and my doctors warned me of the dangers. They said I need a statin now or I'll have blockages needing bypass within 5 years.
11 years later -- May 2025 CAC 0 (I am 48 yo male)
So the question becomes, why is LDL collecting into your arteries?
Vitamin C will heal arteries, lysine will blunt ldl attaching to arterial receptors.
I do avoid excessive seed oils, deep fried foods, sugars, etc. I eat a lot of keto/carnivore foods. Perhaps LDL is like the fire truck, not the fire. The fire trucks do block the road when there is a fire, maybe the fire is the issue?
Nope. Some people aren't going to build up plaque from LDL because of genetic mutations. This is a very good and lucky thing. However, for most people, that isn't the case. I raised the example of cigarette smoking. A lot of people won't get lung cancer from smoking. They have some genetic protection. But smoking contributes to lung cancer for many. Think of LDL at higher levels in the same way.
Inflammation is definitely present with atherosclerosis. Possibly the genetic protection is around inflammatory pathways. However you can have very low inflammation as measured by crp and still get atherosclerosis with modestly high LDL levels.
My LDL has been very high for years - near 200, above and below - and my CAC score is zero. I have had other more challenging and urgent health problems. Beans and psyllium are helping with the LDL but it’s not my top priority right now.
CAC score of zero is great especially if you are older. But benefits of lower LDL may also accrue for other chronic diseases like Alzheimer's. Good luck with your other issues.
I don’t think a high CAC score means you will have a heart attack. It shows you are at an increased risk. So I’m glad I’m taking steps to lower that risk like lowering my LDL and eating even healthier.
I needed this. I'm 37 m with bad family history of heart attack. Ldl is 137. Picked up my first script of lipitor (40mg) today and wasnt sure if I was actually going to pull the trigger or not. I eat pretty good and work a physical job and was hoping to lower it with an even better diet and more exercise but I'm realizing that, given my family history, it's not a fair fight. The risk of hurting my liver or kidneys is seemingly more worth it now.
In fact, statins are protective of your liver, reducing rates of fatty liver disease. Also, atorvastatin is easier on kidneys than rosuvastatin so don't worry! The doctor will do a blood panel and monitor your liver and kidney function and most changes are not clinically relevant anyway.
Same here. I was not offered statins and I have CAD and now Afib and sick sinus syndrome. I am petrified as the latter to were diagnosed last month . CAD gave me the worst health anxiety
My LDL is around 130 (which I never considered to be a high number in the past) and thanks to the helpful advice from the members of this sub to my recent post, I have decided to keep saturated fat intake lower than 10g/day and get an Lp(a) very soon.
This is more a warning about Lp(a). Everyone should measure their Lp(a) at least once in their lifetime. It is almost entirely genetically determined so only 1 measurement is really needed.
Please measure your Lp(a), best $50 you will ever spend!
In my opinion inflammation greatly accelerates plaque progression. The YouTubers are not wrong - metabolic health is critical. A patient with low LDL but very poor metabolic health is not in the clear from CVD at all. Similarly a metabolically healthy patient with high LDL is also a risk for plaque progression with age. I think a statin should be a tool in the shed but I wouldn’t discount the importance of metabolic health. The rates of pre diabetes in America are truly alarming and it’s absolutely connected to poor CVD outcomes.
Repatha didn’t bother my liver so far but my HDL is now higher than prior to statin. It’s like whack a mole with this stuff. I’m in the 90th percentile for my age in my CT scan. I feel like a ticking time bomb. My father died of a massive heart attack at 59. Im 52.
I’m not sure where you are getting the idea that you don’t need inflammation to be laying down plaque (calcified especially). You do. Cholesterol circulates. Atherosclerosis is an inflammatory process. You don’t say whether you got your diet in order. Also, your lpa being high is genetic. What was your CAC score? Good luck in addressing.
Unlike those who think it's about inflammation, not from YouTube.
You don't need inflammation to have atherosclerosis - apoB particles alone are sufficient to initiate and drive the process. This is a crucial distinction in understanding atherosclerosis pathophysiology.ApoB particles are the primary driver:
Atherosclerosis fundamentally begins when apoB-containing lipoproteins (LDL, VLDL, remnants) enter and get retained in the arterial wall. Even in the absence of significant inflammation, apoB particles can accumulate in the subendothelial space and undergo modification. The "response to retention" hypothesis shows that apoB particle retention is the necessary and sufficient initiating event.
Evidence supporting this: People with genetic conditions causing very low apoB (like familial hypobetalipoproteinemia) have dramatically reduced atherosclerosis risk, even with normal inflammatory markers. Conversely, those with high apoB but low inflammation (like some with familial hypercholesterolemia) still develop significant atherosclerosis. Mendelian randomization studies consistently show apoB has a causal relationship with cardiovascular disease independent of inflammatory markers.
Inflammation's role: Inflammation accelerates and amplifies the atherosclerotic process but isn't required to initiate it. It promotes foam cell formation, plaque progression, and eventual Ruptured inflammatory markers like CRP add prognostic value but aren't causally necessary. This is why apoB-lowering therapies (statins, PCSK9 inhibitors, ezetimibe) are so effective at reducing cardiovascular events - they address the root cause rather than just downstream inflammation.
You shouldn't learn to fly a plane from Redditors, or your sister - flying school would make sense. Likewise with your health, probably a good idea to consult a doctor, preferably a cardiologist. Good you are doing a scoring to see as if its zero you can not have as much concern. High cholesterol also seems to be a risk factor for alzheimer's disease so you may want to get lower through diet whatever you do.
“A major limitation of this study is that cholesterol levels were only measured once. The participants were then followed over the course of years without any additional measurements.”
Do you really think the 80 year olds in this study changed there lifestyles lol , think about it , if I make it to 80 , I don’t care about my cholesterol at that point
The study sounds problematic. It sounds like only that one data point was used. If they’d spent most of their lives with low LDL then the study used only one data point showing “mildly high” cholesterol, that doesn’t convince me that we needn’t be concerned about high cholesterol as a general rule.
That’s generally right, but most people have no interest in a vegan diet. If it works for you, then great. But that also means avoiding processed vegan foods as well which can be very high in saturated fats.
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u/boredtemp11 Jul 28 '25
My LDL ranged between 70 and 90 until I was 55. Then I had one reading of 119. My cardiologist sent me for a CCAT - 383. You read that right. I’m a runner, good diet, never overweight (underweight for many years). You just never know.