I have a very high calcium score. What next?

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Thank you for the comments, I should have mentioned that all my stress tests have been exemplary. My triglycerides are normal and my HDL is 59. I have been plagued with anxiety the last 10 years (PTSD) and this CAC score seems to trigger it! I am trying to put it in the “informative” category, however anytime I feel something weird in my chest I become so anxious not knowing if that is a precursor to something bigger. Has anyone tried the red yeast rice as a natural cholesterol reducer?

So, given numbers are important to avoid misunderstanding, your stress tests (you don't say if they had an "echo" component which is recommended with heart disease) should have provided some scoring - like a METS number.

And, same point wrt triglycerides - what number?

My sense is that many folks reporting in on this forum have forced their cholesterol to around 100, and their LDL and triglycerides to around 50 ... usually with a statin, better eating, and perhaps icosapent ethyl.

Re red yeast rice - here's a link to a Mayo article -https://www.mayoclinic.org/drugs-supplements-red-yeast-rice/art-20363074

Here' what it said - please note the specific warning on drinking alcohol with red yeast rice.

"Overview

Red yeast rice is the product of yeast (Monascus purpureus) grown on white rice. The powdered yeast-rice mixture is a dietary staple in Asia and has been used in traditional Chinese medicine.

Red yeast rice is also available as an oral supplement.

Red yeast rice might contain compounds that appear to lower cholesterol levels. One of the compounds is monacolin K, the same ingredient that is in the prescription cholesterol-lowering drug lovastatin (Altoprev).

As an oral supplement, people take red yeast rice for high cholesterol and heart disease.

What the research says

Research on red yeast rice use for specific conditions shows:

High cholesterol (hyperlipidemia). Research shows that red yeast rice containing considerable amounts of monacolin K can lower your total blood cholesterol level, your low-density lipoprotein (LDL, or "bad") cholesterol level and your triglyceride level.
Our take

Yellow light: Caution
Caution

Red yeast rice is capable of lowering blood cholesterol levels and total blood cholesterol levels. While the supplement is generally considered safe, it might carry the same potential side effects as statin cholesterol drugs.

Red yeast rice might cost less than a statin. However, with a supplement, there's less assurance regarding quality and how much active ingredient is actually in the product. Some red yeast products might contain only small amounts of monacolin K and potentially have little effect on cholesterol levels.

Safety and side effects

Red yeast rice can cause mild side effects, including:

Abdominal discomfort
Heartburn
Gas
Headache
Dizziness
Red yeast rice might contain monacolin K, the same ingredient that is in the prescription cholesterol-lowering drug lovastatin. Lovastatin side effects include liver damage and muscle disorders (myopathy).

Don't take red yeast rice if you're pregnant, trying to become pregnant or breast-feeding.

An older study raised the concern that some red yeast rice products contain a contaminant called citrinin, which can cause kidney failure. However, a more recent study that analyzed 14 red yeast rice dietary supplements didn't find citrinin in any of them.

Interactions

Possible interactions include:

Alcohol. Don't drink alcohol if you are taking red yeast rice. The combination might increase the risk of liver damage.
Cyclosporine (Neoral, Sandimmune). Taking this immunosuppressive drug with red yeast rice might increase the risk of myopathy.
Cytochrome P450 3A4 (CYP3A4) inhibitors. Taking red yeast rice with drugs, such as erythromycin, that inhibit this enzyme might increase the risk of harmful red yeast rice side effects.
Grapefruit. Drinking grapefruit juice and taking red yeast rice might increase the risk of the supplement's harmful side effects.
Gemfibrozil (Lopid). Taking this cholesterol drug with red yeast rice might increase the risk of myopathy.
Hepatotoxic drugs, herbs and supplements. Red yeast rice might contain monacolin K, which can cause liver damage in some people. Taking red yeast rice with these types of drugs, herbs and supplements could increase the risk of liver damage.
Niacin. Taking red yeast rice with high-dose niacin might increase the risk of myopathy.
St. John's wort. Taking this supplement with red yeast rice might reduce the effectiveness of red yeast rice.
Statin. Taking red yeast rice with other statins might increase the risk of harmful side effects."

Perhaps consider changing to a different statin, or an injectable that avoids the side effects of oral statins, but has less potential side effects and is more "pure" than OTC red yeast rice?

Well put @christianzane! I'm still struggling to mentally get past the original diagnosis from June, but I've dropped from 250 to 228lbs, I jog/walk 2 miles a day, take a statin and aspirin (with some muscle spasms during long drives) and eating a med. based diet. I'm still needing guidance from a nutritionist as there are many perspectives on how we should be eating, but so far low carb and low fat is getting the weight off and I'm starting to come off blood pressure meds too. I think it isn't stated enough that your risk is greatly reduced if you follow the 7 things you state in your post. Really, your risk is very close to that of the general population if not better because you will be in such great physical shape and other causes of disease and death will also be greatly reduced.

Thank you and don't stress, in people aged 30–70 years old, 25% have vascular calcification.

In people aged over 70 years old, 90% of men and 67% of women have coronary artery calcification.

This is just like HPV. 90% of the population will get HPV. Get a test for it and panic? Of course not. CAC score is different obviously as HPV eventually resolves itself. But you can stabilize the existing plaque, greatly slow the progression of new plaque and go on with your life with dietary and lifestyle modifications.

Sorry you're living in daily fear. I cannot say I am but it seeps into my mind every few days. I'm a fatalist. I do all I can to help my heart....swim, take the right drugs, try to lose weight etc....and if it's not enough, well, then it's not enough. I try to put it out of my mind. But obviously I'm still here and find this forum helpful as well so it's not totally out of my mind 🙂

If/when you write your article could you please share link to it. The added daily stress form this test cannot be a good thing overall...and yet impossible to 'unknow' the results.
Thank you

I have been setting calcium score records for decades now. 5400 when I was your age...8000 now at 78. The key is profusion or dispersion over many years and the hardness of the plaque. Don't fret about narrowing . Just listen to your own opinion of well-being. For people like us with a lot of calcium deposits, the calcium score is a big distraction and worrier. Too much data, not much information or guidance. I'm not saying we're not candidates for issues down the road, but that road can be pretty long and pretty enjoyable. Of course, consider your diet and exercise routines.
Finally, I've found intermittent fasting to be a miracle worker. Lost weight, no joint pain, etc. etc.
Again, be guided by how you feel.

@pumaguy79 At a CAC score of 8000, did you ever need a stent? Have you ever felt any chest pain? That's quite a score! My score this past March was 2534 (at 61 years of age). Absolutely asymptomatic at this point. I consider myself pretty fit for my age. I walk about a mile 5-6x a week, exercise every other day (sandbag training), mostly vegetarian, no alcohol, no smoking. I was put on 20mg Crestor/Rosuvastatin shortly after receiving my score and started taking D3, K2 and CoQ10 shortly after receiving my score. I chose NOT to go on a baby aspirin though due to the risk of stroke, brain hemorrhage and stomach ulcers.

Just curious how you feel with a score that high.

Thanks,

Andy

Hello

Yes sometimes diagnosis itself can be another disease! Calcium score would just mean be more watchful in your life style. It shouldn’t drive you with fear and hence over treatment.
I as a cardiologist was supposed to give a talk on calcium score to the drs of my city, when I casually checked mine : 746!
No symptoms no risk factors. Nuclear test was done and was fine. That was 4 years ago. Now I am 57.
I take rosuvastatin 20 a day and I jog about 60 miles a month. ( one half marathon every month, in around 2 hrs 15 min)

I did have butterflies for few months and slowly I have reduced thinking about it.

Best wishes to all🌱🌱👍