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Need advice after receiving results of my CAC score
I'm a 73 year old retired male living in the Pacific Northwest. My wife (of 47 years) and I are retired and living comfortably and have, up until now, considered ourselves relatively healthy. Most recent BP was 118/68, my lipid panel shows:
Total Cholesterol = 166;
HDL = 58;
Triglycerides = 46;
LDL = 94
On my own initiative I decided to get a Coronary Artery Calcium scan and was shocked to get a result of 4975, putting me in the 98th percentile of high risk. I don't appear to be symptomatic in any way and have (recently) been on an aggressive lifestyle regimen that has included active exercise (cardio/resistance), nutritious diet, and working on my sleep. Nothing prompted this behavior other than general interest in maintaining a healthy lifestyle. My other markers have been excellent so this comes as quite a shock, but reflects a lifetime of poor eating and weight habits. At my heaviest I was at 320 lbs, and as of 2022 made it down to 200. I'm currently at 220 and working my way back down to a decent weight. We don't smoke or drink.
My primary has referred me to a cardiologist who I will see later this month. Until then, I'm just trying to deal with this news and wondering how to formulate meaningful questions for that visit, while gathering up as much additional research and advice as possible.
My primary is recommending I start 20mg Rosuvastatin and I await my pharmacy. I assume a cardiologist will endorse this and update as needed.
Meanwhile, I'm eager to learn more about what I should expect, what can be done, and how others are coping with this, or suggestions from the health community.
Thank you,
Bob in Seattle
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Most do what you do if they are motivated to live well and longer. I think you're doing what you can, even if it's a tad late. The score, by itself isn't a disaster, if worrying. It might be a reflection of all those years of married bliss, during which you gained bit of butter here and there. IOW, it took a while, and is probably not an indicator of what has gone wrong in the past five years. This is just a guess; I know nothing of your history, any infections, other drugs and treatment, other habits besides the iffy eating habits. It's good you don't smoke or drink or that number might be twice that by now.
As I understand things, this is just a snapshot of what is extant in one or more measured places. Like the problem with quantum physics, you cannot know an object's direction and speed and its appearance at the same time. You get one type of information, speed and direction, or what it looks like...take yer pick. It's sort of the same with the CAC. You can get a good estimate of what is in place, but you don't really know if it's stable or going in the wrong direction....climbing. Assuming it is climbing, your physician has prescribed a low initial dose of a statin, hoping it will stop any further accumulation. I was initially on that dose, but when my heart began fibrillating more and more, he felt ischemia might be the issue and ordered another 20 mg, so I'm up to 40 now. In case that sounds worrying, I know of a woman who takes 100 mg.
You should expect nothing more. Annual monitoring, blood test, maybe another CAC in two/three years for that directionality thing, and more encouragement to manage things on your own to the extent you can without having to take more drugs. When any one important vessel gets 70% occluded, that is when they will begin to talk about a bypass or stent...but a lot depends on your symptoms. If you seem fine, they're fine.