Must you change your diet if statins are doing the job?

I actually like whole foods, like vegetables, whole grains, lean proteins and healthy fats. To me, they taste better and are more satisfying. Not loaded with as much sodium and chemicals either. Each one to his own choices, but I don’t really like fast food and a lot of processed stuff. I like the way I look much better when I’m eating right, too. My energy level is better and I’m not hungry a lot.

Oh, my total cholesterol was 160 before I started a statin last year.

My two cents: Your lipid profile and associated key ratios of LDL and HDL is more complex than just a cholesterol level. I have family who took the statins, exercised, ate pretty healthily, had what appeared to be good numbers and still had to face a double bypass.
So almost no one does diet and exercise like we should or could - but it’s a risk to throw caution to the winds.

The statins are like DOACs...Direct-acting Oral Anti-Coagulants. The DOACs don't prevent clotting, they merely retard the action so that your heart can flush out 'stale' blood before it actually clots if it is fibrillating and the left atrial appendage is not getting 'irrigated' quite as well as when one's heart is in normal sinus rhythm. Statins are somewhat similar, but they also have some unfortunate 'side-benefits', such as preventing your body from making its own co-enzyme Q10. If you simply must take them, statins reduce the liver's ability to produce low-density lipids, but they don't absolutely stop all such production. So, depending on the dosage (and now you realize that the answer is dependent on one's choice of food as well as her willingness to take the prescribed dosage of statin), you might stop 80% or only 40% of your liver's production of LDL.
https://www.healthcentral.com/article/can-you-eat-whatever-you-want-while-taking-statins-for-cholesterol

I'm afraid I don't understand your reply, but at least you tried to address my question, as opposed to the first response. The article you posted also doesn't answer my question (I actually read it earlier today in hopes of answers while googling).

Let me rephrase in a diffent way: If two patients have the exact same cholesterol numbers, BP control, healthy weight, active lifestyle, and all the rest is identical, is the one who eats well any less likely to suffer a cardiac event than the one who eats poorly? And if yes, how do we know this and how might we measure it? Would a doctor be able to tell which is which, and if so, how would they know?

Short answer is no - said doctor cannot precisely parse cause and effect. Recommendations are based on mountains of correlations, and some very broad indications of impact: eating animal fat matters a lot and we can measure saturated fat levels. Giving your body an opportunity to use lipids vis exercise also a priority but we don't have a direct measurement of that effect.

You get the idea.

I wonder if any of the presentations on Low Carb Down Under (YouTube) would address your question.

Hey PB: Can you clarify what you mean by this sentence? Giving your body an opportunity to use lipids vis exercise also a priority but we don't have a direct measurement of that effect."

Also, how do we measure saturated fat levels?

Mediterranean diet , 150 min of cardio exercise weekly .

@lp77 I don't understand the point of posting something that in no way answers the questions posed.

The point was along with statins eat a Mediterranean diet and get 150 weekly .
This is recommended by cardiologists .