I follow the most recent American College of Cardiology guidance on the use of statins for primary prevention of cardiovascular (CV )events. The first step is to estimate the 10-year risk of an event with a calculator (
https://www.cvriskcalculator.com/). Once you have that info, this flow chart (
https://www.acc.org/latest-in-cardi...a-guidelines-on-the-primary-prevention-of-cvd) leads you through the process. Your PCP may have done that calculation in his head, or more formally, but getting an objective risk assessment is important for personal planning purposes ("Do I need to call my life insurance agent today?") and to guide therapeutic options.
From the original post, I would be concerned about the diagnosis of insulin resistance (rising A1c levels and hyperlipidemia), or "pre-diabetes/metabolic syndrome", and eventual progression to overt diabetes. Getting that sorted out first will make some difference in lipid therapy, as statin treatment is indicated for all diabetics, regardless of their other risk factors.
The diagnosis of diabetes is equivalent to a prior MI in terms of risk for future CV events. It may also goad you into some lifestyle modifications that will affect both blood glucose and lipids, as the FAA has their own hoops when it comes to medications for diabetes that could affect your flight status.
Statins are very effective at preventing stroke and MI, and the effect is seen rapidly after starting therapy. Only few people experience side effects severe enough to limit therapy. That said, if you are diagnosed with insulin resistance, getting that fixed helps lower the lipid levels.
Having a fatal MI never scared me too much. Having the "just shy of fatal MI" is the real worry.
V/R
