Physician with family CVD history seeks dietary changes and CAC before statins

[AlexanderT]

I'm a primary care physician in my forties with a strong family history of early cardiovascular disease, and despite being physically active, my recent lipid panel showed borderline high LDL cholesterol. My own doctor suggested starting a statin, but I'm hesitant and want to exhaust all lifestyle modifications first. For other healthcare professionals managing their own cardiovascular disease prevention, what specific dietary changes beyond general "heart-healthy" advice had the most significant impact on your lipid profile? How do you balance the evidence for medication with the desire to avoid lifelong pharmaceuticals, and what monitoring parameters do you use to assess whether lifestyle changes alone are sufficient over time? I'm also interested in the role of advanced lipid testing and coronary calcium scoring in personal risk stratification.