There are some great responses here.

I fought against taking statins from age 40 to 54 and know many the arguments against them. At an annual exam in December 2021 my primary told me he would no longer be my doctor unless I start on statins. My wife is a family medicine MD who follows AMA and AHA guidelines with her patients, so I knew her opinion. History of heart disease and early death on both sides. I was 54 y.o. with 240 cholesterol and no symptoms, active, with a great diet and I decided to give in.

I commited to navigating through the potential side effects of statins.

We tweaked the dosage once and then added a second statin and then fast forward 2.5 years to now. There have been zero adverse side effects and m cholesterol is 100.

However, I did learn my CAC is 1,208 now.
Follow up tests came back with a normal echo and no blockages. The statins did their job.

Inflammation is the underlying enemy.

I think our best role is to look for ways to reduce inflammation and to slow or stop the progression of plaque build up.

Statins are a powerful anti-inflammatory and many of us don't have any struggles with them. If the upside potential outweighs the downside potential it may be worth a try. You're asking good questions.