1. < Heart & Blood Health

CAC score in 95th Percentile - Next Steps?

Posted by sunnysky @sunnysky, Sep 14, 2023

Hello,

I am turning 50 and recently had my annual physical. My BMI is 21. I am on no drugs currently. I eat a heart-healthy diet and exercise regularly.

Here are my cholesterol results:
Cholesterol: 165
LDL: 93
HDL: 56.

I have a strong family history of early-onset heart disease. My dad had his first quadruple bypass in his mid forties.

My coronary calcium (CAC) score came back at 30, which is in the 95th percentile for my age.

My primary care physician noted that my CAC score was "good" and recommended no changes to my lifestyle or any medication.

But I am concerned that my CAC score is in the 95th percentile, despite my diet and exercise, and my family history of early-onset heart disease. I want to stop the progression of my heart disease.

My question: should I seek a second opinion about whether medication might be appropriate in my case? I would certainly be willing to take a statin if that would help.

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gloaming | @gloaming | Sep 14, 2023

If it were me, I would seek an echo-cardiogram or another type of test to determine CA deposition/plaque in the heart's own blood supply, but also in the carotid artery (Doppler ultrasound can help in this particular instance). But you really ought to put these questions to an expert, even a second or a third opinion if it will help you to 'triangulate' your way ahead. I'm no expert, but your LDL ratio doesn't look very promising, and when added to your CA score, PLUS....your genetic history...I would think you're going to need at least another helper advising you, maybe a cardiologist.....??

All that verbiage posted, I would have to say yes!

REPLY
1 reply
bitsygirl | @bitsygirl | Sep 14, 2023
In reply to @gloaming "If it were me, I would seek an echo-cardiogram or another type of test to determine..." + (show)
@gloaming

If it were me, I would seek an echo-cardiogram or another type of test to determine CA deposition/plaque in the heart's own blood supply, but also in the carotid artery (Doppler ultrasound can help in this particular instance). But you really ought to put these questions to an expert, even a second or a third opinion if it will help you to 'triangulate' your way ahead. I'm no expert, but your LDL ratio doesn't look very promising, and when added to your CA score, PLUS....your genetic history...I would think you're going to need at least another helper advising you, maybe a cardiologist.....??

All that verbiage posted, I would have to say yes!

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I have a family history of heart disease too - but my score was almost 600 before I had the scan. You are wise to take action now. The scores are absolute, as I understand it, and yours is low. (Look up Agatston score if you haven’t already.) I suspect that is why your doctor did not put you on statins. My score was so high, I just went on them, but there is some controversy I gather for people with low scores.

I’d suggest seeing a cardiologist — s/he should be an expert on prevention. After my score I read “Beat The Heart Attack Gene” and found it to be a good place to start trying to come up to speed on what can be done.

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mayoconnectuser1 | @mayoconnectuser1 | Sep 15, 2023

My math indicates pretty good HDL and LDL ratios ... am I doing this wrong?

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1 reply
swilkins1974 | @swilkins1974 | Sep 15, 2023

You sound pretty healthy to me. If I didn’t have to be on a statin I wouldn’t.

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pumaguy79 | @pumaguy79 | Sep 15, 2023

For some readers, this is a repeat message. I'm an active, 78 year old male. My first calcium score(Heart Check ) came in at a mere 5900 in 1997( age 53). I was devastated, just waiting for a catastrophe. I spoke with the inventors of the then-new CT technology. I was in the 99 plus percentile. I was told then, as I have been told ever since, that the calcium score indicates plaque, but the hard(good) type not soft(bad). Some people disseminate plaque throughout their body, some concentrate it. My most recent CCT revealed a score of 8000 at age 78 Since I am symptom free, walk 2 miles each day, lead an active life. live in an apartment with 14 steps that I traverse numerous times per day, I am not inclined to risk a cath lab experience just to find out what I already know. If I develop painful, persistent angina or life-changing fatigue, I'll try to get to the front of the line for invasive procedures, but not now...not with the "normal"(for a 78-year -old) life I enjoy so much.

Either a person has plaque or they don't. I believe only hard plaque glows on a CCT so many folks are walking around without test results who are at much more risk of an event than you. Ergo the broad use of statins in society.

Keep calm. Eat right. Stay active. Live a long life.

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3 replies
sunnysky | @sunnysky | Sep 15, 2023

Thank you, everyone, for the feedback. This is a great community! I got a copy of the "Beat the Heart Attack Gene" and started reading it last night. I made an appointment with a cardiologist for a second opinion. Like everyone on this thread, we want to prevent the progression of the disease. I figure the cardiologist would be the next best step. I am also grateful for my health and as you say - keep calm, eat right, and stay active.

REPLY
questionofbalance | @questionofbalance | Sep 16, 2023
In reply to @pumaguy79 "For some readers, this is a repeat message. I'm an active, 78 year old male. My..." + (show)
@pumaguy79

For some readers, this is a repeat message. I'm an active, 78 year old male. My first calcium score(Heart Check ) came in at a mere 5900 in 1997( age 53). I was devastated, just waiting for a catastrophe. I spoke with the inventors of the then-new CT technology. I was in the 99 plus percentile. I was told then, as I have been told ever since, that the calcium score indicates plaque, but the hard(good) type not soft(bad). Some people disseminate plaque throughout their body, some concentrate it. My most recent CCT revealed a score of 8000 at age 78 Since I am symptom free, walk 2 miles each day, lead an active life. live in an apartment with 14 steps that I traverse numerous times per day, I am not inclined to risk a cath lab experience just to find out what I already know. If I develop painful, persistent angina or life-changing fatigue, I'll try to get to the front of the line for invasive procedures, but not now...not with the "normal"(for a 78-year -old) life I enjoy so much.

Either a person has plaque or they don't. I believe only hard plaque glows on a CCT so many folks are walking around without test results who are at much more risk of an event than you. Ergo the broad use of statins in society.

Keep calm. Eat right. Stay active. Live a long life.

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Great post. Are you on statins? What is the negative? I just received a scary 700 score at 64 and in good shape otherwise. They doubled my statin from 20 to 40mg.
2 month wait to see cardiologist. All are not the same. What should I look for in a cardiologist?
What is the risk of a 'cath lab experience'?
How do we measure good vs bad plague?

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2 replies
cianci | @cianci | Sep 16, 2023
In reply to @pumaguy79 "For some readers, this is a repeat message. I'm an active, 78 year old male. My..." + (show)
@pumaguy79

For some readers, this is a repeat message. I'm an active, 78 year old male. My first calcium score(Heart Check ) came in at a mere 5900 in 1997( age 53). I was devastated, just waiting for a catastrophe. I spoke with the inventors of the then-new CT technology. I was in the 99 plus percentile. I was told then, as I have been told ever since, that the calcium score indicates plaque, but the hard(good) type not soft(bad). Some people disseminate plaque throughout their body, some concentrate it. My most recent CCT revealed a score of 8000 at age 78 Since I am symptom free, walk 2 miles each day, lead an active life. live in an apartment with 14 steps that I traverse numerous times per day, I am not inclined to risk a cath lab experience just to find out what I already know. If I develop painful, persistent angina or life-changing fatigue, I'll try to get to the front of the line for invasive procedures, but not now...not with the "normal"(for a 78-year -old) life I enjoy so much.

Either a person has plaque or they don't. I believe only hard plaque glows on a CCT so many folks are walking around without test results who are at much more risk of an event than you. Ergo the broad use of statins in society.

Keep calm. Eat right. Stay active. Live a long life.

Jump to this post

Wondering if you take statin, baby aspirin or anything else?
What kind of diet do you have?
Also blood pressure and cholesterol?

REPLY
1 reply
debwellmadebeh | @debwellmadebeh | Sep 16, 2023
In reply to @pumaguy79 "For some readers, this is a repeat message. I'm an active, 78 year old male. My..." + (show)
@pumaguy79

For some readers, this is a repeat message. I'm an active, 78 year old male. My first calcium score(Heart Check ) came in at a mere 5900 in 1997( age 53). I was devastated, just waiting for a catastrophe. I spoke with the inventors of the then-new CT technology. I was in the 99 plus percentile. I was told then, as I have been told ever since, that the calcium score indicates plaque, but the hard(good) type not soft(bad). Some people disseminate plaque throughout their body, some concentrate it. My most recent CCT revealed a score of 8000 at age 78 Since I am symptom free, walk 2 miles each day, lead an active life. live in an apartment with 14 steps that I traverse numerous times per day, I am not inclined to risk a cath lab experience just to find out what I already know. If I develop painful, persistent angina or life-changing fatigue, I'll try to get to the front of the line for invasive procedures, but not now...not with the "normal"(for a 78-year -old) life I enjoy so much.

Either a person has plaque or they don't. I believe only hard plaque glows on a CCT so many folks are walking around without test results who are at much more risk of an event than you. Ergo the broad use of statins in society.

Keep calm. Eat right. Stay active. Live a long life.

Jump to this post

Thank you for sharing your history, it gives us hope! We need more stories like yours.

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1 reply
pumaguy79 | @pumaguy79 | Sep 16, 2023
In reply to @debwellmadebeh "Thank you for sharing your history, it gives us hope! We need more stories like yours." + (show)
@debwellmadebeh

Thank you for sharing your history, it gives us hope! We need more stories like yours.

Jump to this post

Dear debwell,
My story may end tomorrow(suddenly) who knows? But I’ll always be glad that I resisted more aggressive treatment option when they just didn’t seem appropriate to my circumstances. Prolonging life is not such a hot proposition if the price is needlessly giving up
years of active well-being.
Cheers.

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