Any women with high CAC scores?

Hi @anniehall56 and welcome to Mayo Clinic Connect. I know that it must be awful to think that at any moment something could go wrong and you could have a heart attack or stroke. The good thing is you were an advocate for yourself and caught it and are now doing something about it!

I would like to invite @yoanne, @mayofeb2020, @hopeful33250, @elizabeth1941, and @degarden_girl to the conversation to share their thoughts and feelings about your experience and to also share with you theirs.

I have read that things such as soy nuts and unsweetened soy milk contain isoflavones that act as estrogen which builds up the number on LDL receptors in your liver. You can read the whole article here: https://southdenver.com/lower-your-calcium-heart-score/

@anniehall56, Have you had repeat blood work since losing 15 pounds and changing your diet? Is that something that UCLA will do next week?

Hello @anniehall56,

My first word of advice might seem very trite to you and it isn't meant to diminish the concerns you have but, "take some deep breaths" on a regular basis. I can only imagine how frightened you are but fear alone won't help. (I know that this is easier said than done,)

While I've never had a high calcium score, I've had heart problems for a long time as well as three surgeries for a rare form of cancer. I understand how we often spend a lot of time "looking over our shoulder" and waiting for the other shoe to drop. As much as possible, try to refrain from that. Work at distracting yourself from worry. Worry doesn't solve a heart problem. If it did we would probably all have great scans.

When you have a chronic illness, like you, and so many of us do, we need to think in the long-term. Keep focused on educating yourself about your health situation. Use research tools, talk with your medical professionals and maintain a healthy lifestyle as you have been doing. Practice whatever relaxation techniques that you are comfortable with. The most important thing to realize is that you are in this for the long haul and you need to develop a mindset that will help and not hinder you. Does this sound possible?

I would love to hear from you after your next appointment. Will you post again?

Hello again @anniehall56,

I noticed that on Connect we have another discussion on high calcium scores. Many members have posted about their experiences there. Here is the link to that discussion.
https://connect.mayoclinic.org/discussion/high-calcium-score/

@anniehall56. I understand your overwhelming shock and dismay at your blood test results. We think we are doing everything right and then are stunned when we are diagnosed with a serious health concern. You are fortunate to have high quality medical care so available to you.

I had the calcium scan in 2007 and the score was about 500, most in the LAD and that score supposedly indicated I was in imminent danger of a heart attack. So far, no chest pain, no heart attack. I am now 76 years old and have some degradation of aerobic capabilities with age but I still walk faster than friends 10 years younger.

My cholesterol numbers were supposedly OK back in 2007 because I am a woman and my HDL was over 100. After I had the calcium scan and saw my male cardiologist he was shocked because "you're a woman and your HDL is so high". I believe thinking along that line has changed since then.

I was prescribed statins but couldn't tolerate them and tried to control my levels through diet and fish oil. But since so much of the cholesterol in the body is a result of genetics, I just couldn't bring down the numbers. Then, bless the scientists, Praluent was developed and proven effective in not only bringing down cholesterol levels but also in reducing deaths. I was prescribed that about 3 or 4 years ago and my cholesterol fell to about 150. LDL fell and HDL, although lower was still in the high normal range.

I consider myself fortunate to have opted for the calcium scan which started this change in how my cholesterol levels were being seen. My Dad died in 1962 at age 50 of a myocardial infarction. Back then there was so little known about heart disease and no real medications to treat it. But now it is recognized what a role genetics plays in this whole medical issue.

I would not search for alternatives to taking a statin. If you can tolerate them, they do the trick -- not only do they reduce the lipid profile numbers but also, they have been proven to reduce death rates in those taking them. Statins and the injectable anti cholesterol drugs are the gold standard.

I wish you peace and a good experience with your new cardiologist.

Donna

@anniehall56 Another suggestion to help bring cholesterol numbers down is to eat lots and lots of fiber -- not just from fruits and vegetables but beans and lentils, whole wheat bread. Simple carbs are apparently responsible for high triglycerides so replacing pasta with a complex carb might be helpful.

This article may give you some idea of what the doctors may recommend. Ultimately risk factor management that you have started. However keep us posted.

I am wondering if they will also do / recommend anything for the A1c. Also, how is your BP.

If they are recommended, I would suggest not refusing meds in addition to the important lifestyle things you are doing. Especially if any specific meds likely prolong life / reduce events based on your factors/risk factors.

See this early information as a gift but don’t fear normal things.

Good job being proactive, motivated, and active.

I think this is my first posting in this group. I'm a 76 year old woman, former jogger, with a CAC score of 1025. In 2015, after asking my PCP about the advisability of taking baby aspirin because my father had died of a massive heart attack at 57, I wavered about getting the scan he suggested despite his own surprise at having his own score be higher than he would have thought. And he's a marathoner! In January of 2016 I decided to have the scan and the results were shocking to my doctor as well as me and my husband! I've always been the EverReady bunny, plenty of energy and loved to jog - up to 6 miles sometimes. But my results - LM-349;LAD-640;LCx-36;RCA-0;PDA- 0;Other-0 put me right into that ticking time bomb category. I quit running because I was sure I was going to die on a run. Because I was asymptomatic, he didn't feel I needed a cardiologist and he put me on 40mg of atorvastatinand a baby aspirin and ordered an exercise stress test which was unremarkable. After 3 months all my lipid numbers were much better (sorry I don't have the earlier numbers) - Total cholesterol 167, Triglycerides 73, Ratio 2.0, HDL 83 and LDL 69. I had a very healthy diet prior to beginning the statin, so I really have to credit it, not my giving up foods I love.

Two years ago in February (2019) I had an episode of shortness of breath (that turned out to be "Political Anxiety" haha) and after seeing a pulmonologist was sent to a cardiologist who had me do another exercise stress test which was again fine, but he changed my meds to 20 mg of rosuvastatin because I'd complained of some neuropathy in my feet since beginning statins and he felt that would be better for me. When I saw him in November of that year my he changed the strength to 40mg of rosuvastatin because he wanted to get my LDL lower and now my numbers are: Total cholesterol: 154, Triglycerides 82, ratio 1.9, HDL 82 and LDL 58. He's very pleased with where I am and so am I. It has taken me these 5 years to finally believe that I'm going to die in my sleep, because I'm doing all I can to stick to a healthy life style. And I realized that when I read your post: I'm past the serious anxiety I had. We have pasta (with a non-meat sauce) at least twice a week and red meat once or twice a month, which I don't miss all that much, I have to say. I have not given up wine. I try to exercise every day and even power walk around my house for 30 minutes if there's too much snow on the ground or the weather's bad. It's been helpful to read others' posts on the the High Calcium Score thread - so many there with long time high scores who are not just existing, but turning their backs on the test results and just proactively living the healthiest life they can.

I agree that the test can be a blessing and a curse, but I've come to see it as a wake-up call and leave it at that. Mostly I say, believe in the science. Soon your score will just be another number. Personally, I'm glad I had it done because it's made me aware of and in charge of my own health in a way that my Dad never was, and I've lived to see 4 grandchildren born, which he sadly was never able to do. Sorry I've gone on about this, but I know at this point you're happy to read good news!

So here's the update. I saw Doctor Budoff who looked at my CAC score and did some math and told me that my density was good, which means, from the way explained it, that it took a long time to get to the state it's at - 255, all in LAD, so very calcified. He said he believed that the strict diet I'm on- low carb but not keto, eating fish and lean white chicken a couple times a week, no white stuff- pasta, breads, etc., just lots of greens, and exercising five times a week 45 minutes a day of aerobics plus some weights in between, would stop the progression. I hope he's right. I asked him about the poor outcomes in his studies and he said that most of these people go untreated, or keep doing these as usual- poor lifestyle, smoking, etc. He suggested a new drug, Nexlizet, which I haven't started taking yet.. I wanted to get all my bloodwork back first to see if I've been able to do anything without drugs.. He wants me to send him my bloodwork and then talk again which I will do by Monday. I repeated everything last Friday and got everything back this week and was pretty impressed. Will share below. Need to decide on the drugs, and still concerned about the LDL, APOB and LDL- not thrilled that the APOB went up. Teeter between the low carb vs. vegan diet. Anyone have any suggestions? Anyway, I guess the reversals below are pretty good - Just he HS-CRP and A-1C had me feeling positive, but still have to keep going to get them all where they need to be. Just wonder if the APOB and cholesterol are going to need some drugs to make them move considering my family history. Love hearing your thoughts. I still feel like a time bomb but Budoff didn't seem alarmed.
11/20/20/ 2/12/21
Total Cholesterol 280/ 228
HDL 63/ 58
Non-HDL 217/ 170
LDL 172/ 138
Triglycerides 272 / 188
Fasting Glucose 170/ 124
GGT 34/ N/A
HS-CRP 10/ 0.5
A1-C 6.6 / 5.7
ANA Positive/ Negative
TSH N/A/ 2.49
Fasting Insulin N/A/ 3
APOB 100/ 115
Homocysteine 13.1/ 13.6
LP-PLA2 N/A/ 109
APOE 2/3/ N/A
LPa Negative/ N/A

Donna, thanks so much for your very hopeful response! Glad to know you're doing so well!

It sounds like you are on a great path. Good doctor, plan forming, and making course corrections before symptoms or cardiac events. You are being proactive. For many these are an actual “U-turn” after major problems.

For your diet I am guessing based on your posts, if your doctor agrees, you may be most happy long term (and happy adds to healthy) if you gravitate to/near the Mediterranean diet. You can make any modification you learn about or desire, but again it is a total guess. You can also still have some pasta and other things with whole grains you may enjoy, seafood is encouraged, and it will improve “your numbers” and is backed by clinical studies showing benefit and is enjoyable. Seeing a good nutritionist/dietician, possibly one connected to the cardiac rehab program of a good hospital may also give you insight and momentum. The one question is you noted your doctor noted “low carb” so maybe confirm he supports Mediterranean and all the fruits and veggies (and some healthy carbs).

The med you noted contains “Ezetimibe” that is a good one from a side effect risk perspective. Don’t fear the meds, especially to extremes, but ask and learn if they will (1)make you feel better and/or (2)extend your life. Sometimes the answer is different then you expect and can help guide your choices.

Best of luck with your journey but it sounds like you are well positioned, staying active and doing the right things.