u/Minimum-Ad-394

I'm trying to decide whether the potential benefit of lowering my ApoB/LDL further is worth starting a low-dose statin.

I'm 62F, 5'6", ~152 lbs, non-smoker. I take lisinopril 5 mg daily; BP is typically around 120/70.

Current labs:

• LDL-C: 120

• ApoB: 91

• HDL-C: 112

• Triglycerides: 59

• Non-HDL-C: 130

• Lp(a): <6 mg/dL

• ApoA1: 211

• Total cholesterol: 242

CAC score: 0

I've already made a significant dietary effort since February — eliminated red meat and substantially reduced saturated fat. My LDL was 119 and is now 120, so essentially no change.

I'm not diabetic and have no known cardiovascular disease.

My question is really about risk reduction vs. medication burden:

If these were your numbers, would you:

• Leave things alone and monitor because CAC = 0 and Lp(a) is extremely low?

• Try a low-dose/intermittent rosuvastatin or another statin to bring ApoB/LDL down?

• Consider ezetimibe instead?

• Set an ApoB target (e.g., <80) and try to reach it?

How much weight would you give a CAC of 0 at age 62 when deciding whether to treat an ApoB of 91?

I'd especially appreciate perspectives from people who have made a similar decision with CAC = 0.

I'm looking for feedback on whether people with my numbers would consider a very-low-dose ("microdose") statin, another lipid-lowering option, or no medication.

I'm 62F, 5'6", ~152 lbs, and a non-smoker. I take lisinopril 5 mg daily for blood pressure, which is typically around 120/70.

Current numbers

• Total cholesterol: 242

• LDL-C: 120

• HDL-C: 112

• Triglycerides: 59

• Non-HDL-C: 130

• Chol/HDL ratio: 2.16

• ApoB: 91

• ApoA1: 211

• Lp(a): <6 mg/dL

• CAC score: 0

I have no known cardiovascular disease and am not diabetic.

What I've already tried

Since February, I've given up red meat and significantly reduced saturated fat specifically to see whether I could lower my LDL.

My LDL was 119 and is now 120, so essentially no change despite those dietary changes. My triglycerides remain very low at 59.

I'm not looking to keep eliminating more and more foods indefinitely if my numbers aren't responding.

What I'm trying to decide

Given the combination of LDL 120, ApoB 91, HDL 112, triglycerides 59, Lp(a) <6, and CAC 0, would you:

• Do nothing and monitor?

• Try a very-low-dose statin, such as low-dose rosuvastatin or pravastatin?

• Consider ezetimibe instead of a statin?

• Continue lifestyle changes and try to get ApoB below 80?

• Aim for a specific LDL/ApoB target despite the CAC score of 0?

I'm particularly interested in hearing from people with CAC = 0 who have made a similar decision about statins.

Also, how much weight would you give my HDL of 112?