In lower-risk people, the absolute benefit of taking statins is small, and if your calcium score is zero, short-term event risk is often already low. That’s why “statin first” can miss the point. There’s also the trade-off: some people notice muscle symptoms or a bump in blood sugar. If insulin resistance, thyroid issues, poor sleep, or chronic stress are driving your cholesterol, a prescription won’t fix those. A smarter path starts with better markers (think ApoB and, when needed, Lp(a)) and a