Extremely high calcium score at 42 - is there any positive here??

Posted by steveny @steveny, Jul 8, 2022

I'm a 42-year-old male. Exercise regularly, not overweight, non-smoker. While not overweight, I will say that my diet is crap -- way too much fast food, pizza etc. I guess I still eat like a high schooler.

Anyway, I saw a cardiologist figuring after age 40 this would be wise. He took bloodwork which was basically all fine. The cholesterol was *slightly* elevated and he recommended getting a heart calcium score. Told me he expected it would show nothing but that he just wanted to be thorough. Turns out the score came back at 397.

Obviously, this caught me totally flat-footed. I figured with my diet there might be some plaque, but this number places me in the 99.999th percentile for my age. And everything I have read online sound pretty dire about my long-term prognosis now -- that significant damage has been done, that it can't be reversed and can only get worse and that the statistical linkage between a number like this and heart attack-stroke is profound.

Weirdly, the cardiologist did not seem to be conveying any alarm when he told me the score, though. He was extremely matter of fact about it. Just said it was "very, very high" and that he would put me on a statin (which I've already started) and that I should take daily baby aspirin (doing that too). He said I should focus on improving diet and continue exercising (I already run 4-5x a week) but he was also pretty emphatic that "this must be genetic." (There is a history of heart problems on my father's side of the family -- though he is 76 and has yet to have any heart trouble himself.)

This was all a lot to get hit with at once. From the doctor's casual, matter of fact tone, I left the office a little confused, wondering if maybe this score wasn't that big of a deal and was a very manageable thing. Why else would the doctor not seem that disturbed by it? But then I started reading everything I could find on the subject and it's been pretty devastating.

Obviously, I'm ready, willing and able to implement the dietary changes, but for the score to be this bad at this young of an age (and with no smoking history, not being overweight, and doing regular exercise), it seems like I'm in serious trouble here. So upsetting to read that I can't bring this number down.

I guess I'm just posting this in the hopes that others here might have some experience and insight and be able to offer something, anything that is encouraging? When I read all of the medical material online about high CAC scores, am I missing something? This has all been playing out over the last 24 hours and I feel like I've basically just found out that I could drop dead of a heart attack at any moment and that my life expectancy has been drastically reduced with this news -- and that there's no way to get it back to normal. I now have a million questions for the cardiologist, but when I called his office today I was told he's just started his vacation and won't be back until August.

Any encouragement or practical advice would be greatly appreciated. Thanks.

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My brother has a pacemaker/ defibrillator- one piece. Had his first one so long, had to be updated in the last 2 years has kept him alive for a very long time with a 20-30% function of his heart. I would recommend it.

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Profile picture for kallettla @kallettla

I am sorry about your calcium score. It must be unnerving. I am 68 and have a 0 calcium score, but my carotid is blocked 60%, and my aorta has calcification. I went on the Esselstyn diet for a while. I actually paid to take his course and speak with him. I lost way too much weight. I went from 130 to 117. My sister went from 105 to 95. We both stopped, but it made us very aware of what we were eating. You don’t to take the course, just watch his YouTube. His wife and daughter gave a YouTube food channel. It didn’t lower my ldl much, and recently I found out I have LP (a). That is probably the reason. I was very freaked and my sister has it too. We have taken good care of ourselves over the years, so that was tough to take.

I tried 2 different statins and added ezetimibe. It lowered my LDL to 60. My endocrinologist wants it to be 30. Pharmaceuticals are the only way to do it. Recently, I realized the pain I was having was from the statin:( I stopped taking them and feel much better.
Now my Dr has me on Praluent injections. Cha...ching...pricey. I will add the ezetimibe back when the side effects go away...I hope.

I liked Peter Attia's book Outlive. It has a well rounded way of living. Food, exercise, sleep, stress, face past trauma.

I am looking forward to that new medication for LP a. I tried to get on the Eli Lilly study, but I am too healthy. They are looking for people with obesity, diabetes, HBP ...
You just need to research and do what you can do to have a healthier lifestyle. I hope something here helped you. Best wishes.

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I got into the Lilly study.., you need three qualifiers .. I had high lp a, high CAC and over 65z. They nearly missed my age .. so I feel fortunate to have gotten in.. now I’m hoping I got the drug and not the placebo

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To Steveny.., I had a score of 138 at 42 and at 62 I had a score of 2418z. I think I could have done better over that 20 years, but you need to enjoy life..

Get your lp a tested..,… get your rest, eat better and reduce your stress… try not to overthink the score.. it’s a warning… not necessarily a heart attach ready to happen.. I understand the concern.. but I hear more stories of people living into their 80’s with high CAC scores.. stay positive!

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Profile picture for dnward12 @dnward12

To Steveny.., I had a score of 138 at 42 and at 62 I had a score of 2418z. I think I could have done better over that 20 years, but you need to enjoy life..

Get your lp a tested..,… get your rest, eat better and reduce your stress… try not to overthink the score.. it’s a warning… not necessarily a heart attach ready to happen.. I understand the concern.. but I hear more stories of people living into their 80’s with high CAC scores.. stay positive!

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The OP last posted in December 2023. I hope he is doing okay.

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Profile picture for dnward12 @dnward12

I got into the Lilly study.., you need three qualifiers .. I had high lp a, high CAC and over 65z. They nearly missed my age .. so I feel fortunate to have gotten in.. now I’m hoping I got the drug and not the placebo

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I tried to get in a couple of them, but didn’t make it.

Good luck!

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