I’m in my 50s and on a maximum dose statin which helps to keep my LDL down to around 7 (which is according ot many doctors still high). I have LP(a) but not a lot of it (around the low end of the normal range actually so LP(a) is not my problem).
The problem you are faced with is that statins will not actually help with LP(a). LP(a) is the LDL variant that the liver cannot re-cycle/re-use, so this small LDL particle builds up over time. Even if you body makes less LDL it will still build up. So reducing the amount of LDL your body makes will not meaningfully reduce your LP(a) - if that is the concern.
What you need instead is a PCSK9 inhibitor - but I suspect they will be reluctant to give a 30 year old this as it will most likely require regular injections and is much more costly than a statin. A PCSK9 inhibitor works by helping to improve the recycling of LP(a) particles via a greater number of receptors.
If you have very high LP(a) then you will need apheresis.
You could also try Niacin (a type of vitamin b3) - but make sure it is the flush type. The non-flush type do not work. Niacin is what they used to use before statins were invented - but many people don’t like the side-effect (the flush) of Niacin - and to be honest one does need to build up their tolerance of it. I got to quite like it when I used it (for plaque stabilisation/reduction), but you need 1g a day really.
I don’t believe I have had any side effects from the statins, but my father in law who took them shortly whilst in his 70s had awful side-effects (leg pains) so stopped taking them and most likely due to being a type 1 diabetic ended up with a heart bypass op and then a series of strokes. You won’t know if you will have side effects until you try them.
My LDL is all the large healthy pattern of LDL, not the small dangerous LDL so my risk is now low despite the LDL score of 7 - that is if a more “current” or upto date doctor sees my blood profile. A high LDL score is not bad if the particle size is not small - it’s the small particles that can contribute to unstable plaque which in turn result in rupture and blood clots.
The main benefit of statins isn’t really the cholesterol lowering feature, as studies have shown that statins do not reduce heart attacks or make people live longer - and 25% of all people having heart attacks have low cholesterol anyway. Well let me just clarify that a little, the largest ever study of it’s kind in this area did show an all-cause mortality benefit to statins in one cohort, but only one cohort - ladies over the age of 80.
The main benefit of statins is reduction of inflammation, especially cardio-vascular inflammation. That is the reason the upto date doctors prescribe statins, not for cholesterol. Reduced inflammation is also one tool to turn unstable dangerous plaque into stable plaque. Stable plaque does not result in blood clots or heart attacks.
At your age I would get a full set of lipid tests, including an LDL-p test where they measure the particle size. Sometimes they call this an LDL subfraction test but you are unlikely to get this on our out of date NHS. Other more modern countries like Australia do this as a matter of course. I got mine done at a private london clinic via healthily.co.uk
As for heart attacks, they’re caused by clots of course, so taking a low dose aspirin might be more preventative but I don’t think they reccommend it for secondary prevention nowadays so you would do better to reduce your carb intake to lower your blood sugar levels & insulin spikes, and look after your blood pressure to protect your arterial walls. Losing weight will help massively to keep your blood pressure down which in turn reduces stress on your endothelium.