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

I don't know if fluffy, non-sticky, large molecule cholesterol would have an effect on current players or not. But it's better to have more of it than not, as I understand. I have chronically high cholesterol and the genetic marker for some heart disaster or other but cardio profiles always label me as giving A (optimal) profile. My former cardiologist attributes that good luck to the proportion of non-sticky cholesterol my body seems to make.

Interesting. I'm going to ask about this at my appointment tomorrow. It is interesting to look at these different indicators of disease/risk calculators. I entered my data into the Framingham score calculator today and it gave me a 1.8% chance of an incident in the next 10 years. I then used the MESA calculator -- which includes the CAC score, unlike Framingham -- and got 7.2%. So a four-fold increase basically just from adding in that CAC score.

Just out of curiosity, are you saying high cholesterol is you're only measurable indicator? Have you scored 0 on the CAC test?

That should read "on current plaque"...

Well yes to the high cholesterol but also genetic marker for heart disease and a plethora of deceased relatives who died from heart and/or stroke. So not a good omen. But my recent CAC was five years ago with a score of 4. And, in an abundance of caution, I also had the Endopat test done and had a really good result on that.

A quick note re diet ... my wife and I have been married since age 22 ... we have a nearly identical diet. I probably have a bit more alcohol. She eats quite a bit more desserts than I. I used to run and work out far more prior to age 40.

She scored zero and I scored 1352 ... genetics.

Yep to genetics. A male friend of mine was practically living on lettuce to get his cholesterol down to no avail.

I too was shocked by my score ( 295) at 50 years of age. Statin & baby aspirin seem to be standard treatment . If you retest after being on a statin for a while expect to see a higher score as soft plaque stabilizes. The same goes for weight loss. Check out Dr. Ford Brewer online he has some information I found useful and helped settle me down. Use your score as motivation to live healthy and try not to stress . I know that it is easier said than done but the body is greatly harmed from stress. I take 5g rosuvastatin 3 times a week plus a baby aspirin daily. I am adding ezetimibe based on my cardiologists recommendation as my ldl has not reached his goal. However I believe that it also has a lot to due with inflammation not just ldl. ( I am not a doctor) That's why I chose rosuvastatin as my statin at such a low dose.

An update: I saw the second cardiologist today. He was surprised my score was so high (397) at my age (42) — and especially when he looked at my full blood panel. Total cholesterol at 210, HDL (good) cholesterol is 88; LDL is 110; no diabetes or pre-diabetes; triglyceride level is 43; and CRP of 0.59.

He said he never would have expected someone with this profile to have a score anywhere near this. Gave me hope for a second that maybe, somehow there was an error with the test, but he reinforced that the calcium scan is extremely accurate and reliable.

I told him I was having trouble squaring the dire implications of everything I’ve read about a score like mine with my original cardiologist’s fairly casual attitude toward it. He told me the reality is probably in between my cardiologist’s attitude and my own.

Which means it’s serious. But also that it’s been there for a while; he said it’s probably been building in me for 10 years. Genetics obviously a heavy factor. His main points of emphasis going forward:
* Stress test scheduled for two weeks from now
* Agreed with first cardiologist putting me on Crestor. Said idea will be to smash my LDL below 70 and that if we need to add other drugs (zetia or PCSK-9 inhibitor maybe) into the mix eventually we will. But he was confident that by doing this we will decrease *soft* plaque and limit its future development. Said the calcified plaque will not go away and that the statin might even calcify some more existing plaque and raise my calcium score further.
* Emphasized diet - idea of largely sticking to non-starchy veggies, greens, low carb, some fish and chicken, but try to avoid cheese and cut out fried foods etc. I described what I’d been eating and he thought it was likely helping to push the calcium score up.

My concern is that even with my crappy diet, this calcium score number is crazily high. And it’s not like I have an equally high LDL number that would easily explain it. So I fear that lowering LDL maybe won’t do as much as he’s hoping. But what else can I do? Obviously trying to focus on transitioning to a very different diet. It will be a major adjustment for me, but if it’s what needs to be done I’ll do it.

Of course, that’s my other concern: How do we really know what is and isn’t working? The calcium score won’t be going down, and probably will be going up. I asked him what metrics we should be measuring going forward and he said LDL is the main one - he really believes smashing it under 70 will reverse soft plaques and stop new plaque formation, along with diet. I’m just not sure how this will be measured, again, given that statins will likely raise the calcium score.

Before anyone starts taking statin a careful monitoring of blood pressure is a pre requisite if a person has a low blood pressure then it’s advisable not to take it as it’s side effect is hypotension and the patient can totally crash

I think it is important to realize that a high CAC score may indicate problems beyond coronary considerations. When my cardiologist called me panicked by my over 1000 score the same afternoon that I had the test I thought I was doomed , especially after finding out that my risk of an MI was 20-25% per year. I'm still haer 4+ years later and am still largely asymptomatic. My LDL is only 48 and total cholesterol is 115 thanks to statins and ezetimibe.

However, if your coronary arteries are affected it is very possible that the same mechanism is having an impact on other systems. In my case I have bilateral carotid blockages (not yet to the level that needs intervention, last scan only 39%). My major problem is cerebral microvascular ischemia. The same plaque that is clogging my coronary arteries is slowing killing my brain. Numerous head MRI's show hyperintensities where vessels are are being blocked with brain cell death, as well as multiple lacunar strokes. These were found after TMI's and other neurological issues.

I would encourage anyone with high CAC to be vigilant and aware of these other risks, as well as PAD (which thankfully I don't have!) At least in the case of carotid stenosis there are surgical interventions which can address the problems. Unfortunately, at this time there is no way to roto-root your brain so I just have to live with my white matter disease.

I am 65 and was diagnosed at 61. At least I'm still posting, dead men don't post.