Obviously, I can’t recommend you take any drug, I can only give my one rat n-1 report. I have had lifelong high cholesterol (TC 240-270, LDL 140-180, HDL 70-100) that is completely resistant to any and all lifestyle diet, exercise, supplements interventions. After turning 60, I went on atorvastatin 10mg/day. Initially the statin worked miraculously, got my LDL to 75, TC 155. I was jumping for joy. That was the first year. Every subsequent year it seemed to get less and less effective and I’m back to trash lipids - this past October, TC 239 LDL 146. Oh, and my Lp(a) is a lovely 111. My ApoB is 120. Absolute garbage.
I decided to get s CAC scan at the end of 2023 at age 65 after 5 years of 10mg/day atorvastatin.
The result was a score of ZERO. I could hardly believe it. After a lifetime of toxic levels of lipids with garbage Lp(a), after 5 years of a statin, I have a CAC score of zero. Unbelievable. I don’t fully trust this, so next month I’m getting a CIMT for another data point. Eventually I’d like to get an angio to see if there’s any soft plaque. FWIW, I’ve been supplementing with vitamin K2 for close to 20 years. It was usually just MK-7, but in the last few years I’ve also taken a combo with high MK-4. I have also been taking vit. D3, for some 25 years. Whether that has had any impact on my arteries I don’t have the faintest clue, though yes, I’ve been supplementing with K2 and D3 exactly with the hope that it may help my arteries (and bone health, prostate cancer prevention etc.).
In any case I can’t get my insurance to pay for a PCSK9i, and my PCP has no further ideas to control my lipids, so I’ve taken matters into my own hands. I’ve dropped the atorvastatin back in November of last year and gotten on 4mg/day of Pitavastatin (Indian Pharmacy). I will get a full lipid panel in April to evaluate. I don’t expect miracles from the pita, so I’ve already purchased a modest amount of bempedoic acid and separately a goodly amount of bempedoic acid 180mg + ezetemibe 10mg combo. I will first add the BA for 3 months just to see the effect on my lipids, and then the BA+EZ. I want to crush my LDL to below 60 at a minimum, preferably to 40. We’ll see.
However my point here is that there exist statins that purportedly don’t increase your risk of diabetes, or raise your blood sugar, or cause muscle problems. Pitavastatin allegedly is one like that, plus it is outstanding in MACE prevention. It also has much less interaction with other drugs. And another point is that regardless of your statin use, you are not doomed to have calcified plaque in your arteries. It’s not a certainty as I have found out. Of course, YMMV, and we are all unique individuals with a variety of physiological parameters and reactions to pharmaceuticals.