CAC score now what

Posted by conorder @conorder, Aug 23 10:18am

54 year old very active male. I exercise 20 plus hours a week. Mountain bike and lift weights. My diet is clean for the most part. I relax some on the weekend and enjoy wine and IPAs. I had a cardiac ct scan done due to some chest pains and my CAC score came back as 195. My cholesterol was always right around 200 or lower. I had a ldl of 111 but an Hdl of 75. I was always told that was good. I don’t like the idea of going on statins and I am not sure how to clean up my diet more than it already is, I really enjoy going out to eat but I only do it on weekends and am really strict during the week. This is really hitting me hard and am unsure what my life will be like after this diagnosis. Should I just go on statins and nothing changes? Looking for information from anyone with a similar situation.

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Your CAC score will rise as you age, so there's not a lot you can do. If you go on statins, they'll RAISE your calcium blood levels. The idea is to help to calcify any extant deposits to keep them from flaking, detaching, and running downstream to cause a stroke.

Better indicators of your lipid-associated risk are APOb:
https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.124.068885
and LPa:
https://www.ahajournals.org/doi/10.1161/ATV.0000000000000147
If you go full keto or low carb (less than 100 gm of carbohydrates of ALL kinds), you lipid levels will rise. Many cardiologists are now seeing that this is not necessarily bad. See Dr. Nadir Ali, Dr. Eric Westman, Dr. Stephen Phinney, and all the videos on the 'Low Carb Down Under' channels, all on YouTube. Plenty of pretty-darned-hard-to-discount evidence that they show in graphs, data, newest research (that most physicians don't have time, or can't be bothered, to keep up with).

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@gloaming

Your CAC score will rise as you age, so there's not a lot you can do. If you go on statins, they'll RAISE your calcium blood levels. The idea is to help to calcify any extant deposits to keep them from flaking, detaching, and running downstream to cause a stroke.

Better indicators of your lipid-associated risk are APOb:
https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.124.068885
and LPa:
https://www.ahajournals.org/doi/10.1161/ATV.0000000000000147
If you go full keto or low carb (less than 100 gm of carbohydrates of ALL kinds), you lipid levels will rise. Many cardiologists are now seeing that this is not necessarily bad. See Dr. Nadir Ali, Dr. Eric Westman, Dr. Stephen Phinney, and all the videos on the 'Low Carb Down Under' channels, all on YouTube. Plenty of pretty-darned-hard-to-discount evidence that they show in graphs, data, newest research (that most physicians don't have time, or can't be bothered, to keep up with).

Jump to this post

Thank you. So are you saying stay off the statins?

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More information. I was told I have no blockage just calcium plaque.

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Well, the subject of statins is in real flux these days. Some cardiologists are dead set against them for routine prescription for older folks, including those with determined modest levels of atherosclerosis. Mostly, this is for older people who probably only have another 5-15 years to live. For younger folk, statins might just save them from an early death. Other cardiologists are firm in their convictions that even a year longer is a better life, and statins will help with that. Shrug.

But, to your question. if they are prescribed, take them until you can argue persuasively with the prescribing person. Then, take your chances. But no, you should not stop them because they raise calcium scores. In the case of plaque, you really do want higher calcium scores to help calcify the plaque already deposited hear and there. This acts like a cement, a hardening agent, that helps to keep the plaque from detaching where it exists and being forced by the flow of blood to places where it gets stuck and blocks further blood flow. If that happens, in the heart or in the brain, you're hooped.

You have been told you have no 'blockage'. That means your deposits are not life-threatening...........................................................................................but.....................................................you DO have deposits. Where they exist, you want to hope they're being steadily calcified, as I just explained above.

Here, I run into trouble because I have NOT researched whether someone with naturally high calcium score is about as safe without statins as someone who does not have the high CAC, but is on a statin. Wouldn't it be nice to know? And if I'm right, you can say goodbye to the statin. Except, that's not all the statin does. It also inhibits the production of LDL, or low density lipoprotein. This, apparently, is desirable for those whose LDL levels are sufficiently high that the research suggests you're headed for trouble in just a few years.

BTW, if you are not aware, an unfortunate problem with statins is that they also inhibit the body's ability to secrete its own co-enzyme Q10. This is essential for good heart and muscle function....you need it!. So, when you are taking a statin, you should also supplement with CoQ10. Further, the best formulation is also the most expensive, and it is the 'ubiquinol' formulation, ending in '..ol', and not the more widely available 'ubiquinone' ending with '...one'. Costco in Canada sells the former under the Webber Naturals brand.

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concorder,

This is the aha moment that many of us have as we age ... we find out our genetic predispositions become clear ... even if we have been careful in our life habits.

What tests?
- stress test with echo is appropriate
- advanced lipids test is appropriate
- nuclear stress test might be appropriate
- catheterization if you are symptomatic
- heart ct was appropriate due to chest pain
- do you ejection fraction data?

The concerning part of your post is that you have had some chest pain - on this site many have high and very high CAC - but, are asymptomatic. Some are asymptomatic and end up finding high blockages. Some are symptomatic, but don't have significant blockages.

Ex: On a whim my wife and I got CAC tests around age 65, her - zero, mine 1350. I had started statins due to age and elevated (treated) blood pressure about a year earlier. Asymptomatic. All the non-invasive tests no issues. Stress test very good. CT but calcium tended to reflect so much had to tell, but clearly lots of it. Next CAC 2500. Still no symptoms. Stress test with echo pretty darn good with good pumping, etc. Several vacations with LOTS of hill walking far tougher than the stress tests, Colorado high altitude hiking. Still no symptoms. HDL low 50s (have always been low 50s, even when young while working out in military), LDL 50ish, triglycerides 50ish. Advanced lipids all good. No other health issues. I take a bp med (115/75), atorvastatin 40 mg, 81 mg aspirin (have for 30 years), Vascepa 2 grams per day.

Will have nuclear stress test in October. Cardiologist and others mention positive remodeling likely, so heart over time may have increased size of arteries to account for blockages.

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Thanks for the reply. My concern is going on statins for years. I am reading a lot about the side effects people are experiencing.

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@gloaming

Well, the subject of statins is in real flux these days. Some cardiologists are dead set against them for routine prescription for older folks, including those with determined modest levels of atherosclerosis. Mostly, this is for older people who probably only have another 5-15 years to live. For younger folk, statins might just save them from an early death. Other cardiologists are firm in their convictions that even a year longer is a better life, and statins will help with that. Shrug.

But, to your question. if they are prescribed, take them until you can argue persuasively with the prescribing person. Then, take your chances. But no, you should not stop them because they raise calcium scores. In the case of plaque, you really do want higher calcium scores to help calcify the plaque already deposited hear and there. This acts like a cement, a hardening agent, that helps to keep the plaque from detaching where it exists and being forced by the flow of blood to places where it gets stuck and blocks further blood flow. If that happens, in the heart or in the brain, you're hooped.

You have been told you have no 'blockage'. That means your deposits are not life-threatening...........................................................................................but.....................................................you DO have deposits. Where they exist, you want to hope they're being steadily calcified, as I just explained above.

Here, I run into trouble because I have NOT researched whether someone with naturally high calcium score is about as safe without statins as someone who does not have the high CAC, but is on a statin. Wouldn't it be nice to know? And if I'm right, you can say goodbye to the statin. Except, that's not all the statin does. It also inhibits the production of LDL, or low density lipoprotein. This, apparently, is desirable for those whose LDL levels are sufficiently high that the research suggests you're headed for trouble in just a few years.

BTW, if you are not aware, an unfortunate problem with statins is that they also inhibit the body's ability to secrete its own co-enzyme Q10. This is essential for good heart and muscle function....you need it!. So, when you are taking a statin, you should also supplement with CoQ10. Further, the best formulation is also the most expensive, and it is the 'ubiquinol' formulation, ending in '..ol', and not the more widely available 'ubiquinone' ending with '...one'. Costco in Canada sells the former under the Webber Naturals brand.

Jump to this post

Thanks for the information

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I have been on a statin (atorvastatin) for seven years. If anything has affected me in a way that left me a bit bummed, it was the metoprolol that was prescribed at the same time. It seemed to curb my exercise 'enthusiasm.' I can't say that the third drug I was prescribed when I saw my cardiologist for new AF the first time, Eliquis (apixaban) has affected me at all.

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Thank you for sharing

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@conorder I have genetically high cholesterol and have not been able to get it under control until I found a doctor taking a comprehensive approach to figuring out “why”. I am learning everyone is different, and science is learning more literally every day. I’m not sure Google can catch up quickly or posters online understand it all. If there is a drug that will help me more than hurt me, I want to take it. If there is something I can do myself to make my body work more efficiently, I want to do that. Maybe it will help your doctor if they know your perspective. It sounds like you want to learn as much about what is happening in your body and what risk they cause, instead of the “spray and pray” approach of taking a drug to address an individual blood marker or test score. Kudos!

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