High calcium score: I'm in shock

My GP had told me a high HDL is good and it helps with any bad LDL ?

I'm in shock also and am looking for perspective. Just got results of 1,208 CAC. I'm 57, asymptomatic, active, with a very healthy diet, feel great, and have a family history of CVD on both sides. 2.5 years ago, I had a normal echo and treadmill stress test and just learned now that my CAC was 769 then(!) My primary put me on 20mg Rosuvastatin, 10mg Ezetimibe and 80mg Valsartan and did not refer to a cardiologist. Now total cholesterol is 100 (LDL 44, HDL 40), avg bp 130/70 with 55-60 bpm. My new primary bumped me up to 140mg valsartan and ref'd me to a cardiologist. I have an echo today and a CT Angiogram in two weeks. I am eliminating red meat, eggs, and dairy, and trying not to be scared until we see what the CT Angiogram reveals. In the meantime, I'm scared. I've already outlived one grandfather and watched the other live miserably for 14 more years after a stroke left him half paralyzed at 63. How common is high CAC with low blockage? Any insights are appreciated.

I am not sure how common high CAC without blockage is, but anecdotally, a lot of folks post here that have very high CAC with no problems that require intervention. My CAC is 600ish and I have no blockage greater than 50%. (Not sure how close it is to 50 … I’m in the second category .. >25 and < 50 is my recollection)

It’s usual that your CAC score will go up after going on a statin, because the statin calcifies the plaque and the CAC test picks up on the calcium. There are noninvasive tests that will provide the percent blockage but some doctors won’t prescribe them until you are symptomatic. I was fortunate that because my LAD was involved, the doctor prescribed it. I guess there are pros and cons to knowing exactly what’s going on, but I got lucky and my situation was better than I thought it would be.

You might have your lipoprotein(a) tested. I gather soon there will be drugs to bring it down. You also might be interested in “Beat The Heart Attack Gene” by Bale et al. I have a family history and it was a good introduction to my situation when I learned about the high CAC score. I wish I had read it sooner.

Good luck!

chrisaw,

Your LDL lipid number looks very good, HDL is low (normally something you would address with exercise) ... BP systolic a bit high at 130. What about triglycerides? I'm not a med pro.

A stress with echo (this means echo before and immediately after stress test) should have provided some indication of ejection fraction ... do you have the writeups?

What score did they assign to your stress test? METS?

A huge diet change may not make much difference since the plaque has built up over a long period, and your current LDL is good.

My understanding is a huge diet change will help with progression .

Well, it probably depends on one's baseline. If you're eating fast food breakfast tacos, fast food burgers, steaks and pork chops for dinner with fatty snacks between, then sure. But in these cases medical intervention with BP meds, and cholesterol lowering meds is likely first line (I'm not a med professional) while long term diet modification occurs.

In many of the cases posted here, folks are simply dealing with the long term cholesterol buildup (60 years in many cases) ... so sure, slowing progression with diet change helps, but it took a long time to get to the high cholesterol buildup.

In my case - I've been married for nearly 50 years - we eat at home most of the time. We had kids and when there was no other choice did fast food, but cooked most of the time at home. Net - I ate what my wife ate. Had a bit more alcohol, but pretty much same intakes. Her CAC zero, my CAC 1365.

I take statin, BP med (mild), 81mg aspirin, icosapent ethyl, vitamin. She takes no statin, no aspirin, no icosapent ethyl.

The genetic predisposition ... sorry, got off topic!

It's a fair conversation and I agree that baseline matters.

I'm looking for data showing a causation or correlation between sudden diet changes, primarily a reduction of daily saturated fat from animals, and cvd.

My numbers are managed except CAC 1,208. However, I lost both grandfather's to arteriosclerosis.

Everything I'm finding is data linking saturated fat with cvd progression.

My goal is to stop the progression of lesions and formation of new blockage.

Is there opposing data for more than short-term future?

Im thinking where I'll be in 10 or 15 years.

Yes, it's calcified now. I am wondering about my brain and the rest of my circulatory system that may not have as much blockage yet.

My inner voice is saying the diet that got me here is not going to change direction and get me where I want to go. Years 10-15-20-25...

I am in the same boat but had a NSTEMI at 57. I had a CAC score of 952…but I have been eating well…low carb plant based for over 30 years, exercise regularly, and love life and my job. I have statin intolerance, so could not take statins, but avoided red meat and saturated fats.

It wasn’t until John’s Hopkins tested me for Lipoprotein(a). It is a separate risk for CVD. My test came back at 312 nmol. Get your Lipoprotein(a) tested - it is not included in your lipid panel. You are doing all the right things…and remember…the stuff(calcified plaque) you see is not as dangerous as the stuff the doctors don’t see.

My brother smoked and drank for 40 years, was overweight, stressful job, and had a pretty rough diet from so much travel for work. He has been on low dose statins for nearly 15 years and has a lower CAC score (125), younger than me, and heart attack. His Lp(a) is 188 nmol…still high but less than mine. I think the statins helped him… So sometimes lifestyle doesn’t really matter. 😉

Kindest regards…life is good.

I, too, had advanced lipids test done in mid 2022 - a pretty low 28 nmol.

My CAC increased from 1350 (2019) to 2350 (2023). Started statins in 2017 so perhaps this is continuing calcification.

Probably… I hope you are feeling good and doing well. The heart attack really slowed me down. I don’t know if it is because I am too sensitive, the meds, or the blockages are holding blood flow back. But I realized I never really ever slowed down in my life and just enjoyed it. I am now…life is good.

I hope you and your wife take good care of yourselves and have some fun! 🤩