High Coronary Calcium Score: How do others feel emotionally?

Posted by mcphee @mcphee, Dec 14, 2016

I have a calcium score of 1,950 which is extremely high which means I am at a very high risk for a cardiac event,heart attack,stroke or sudden death.

I take a statin and baby aspirin. I have never been sick, have excellent cholesterol, low blood pressure and I am not overweight. I have no other health problems and I have never been sick. But I feel like a walking time bomb which has caused me a lot of stress. I am 70 yrs old.

I wonder how others with this condition feel emotionally?

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@mayoconnectuser1

Ah, got it - Ramipril is an ACE inhibitor. Which BP med did you use prior to Ramipril? I am assuming you have long had high blood pressure? And, yes, weight loss will affect - way to go!

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Ramipril was my first rodeo with circulatory issues and due to high BP readings. Largely caused by overweight, alcohol drinking, stressed executive lifestyle. Now I’m retired, 0 alcohol, losing weight and regularly exercising.

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@mayoconnectuser1

4aces,

To my knowledge there is nothing that can be done to lower calcium scores; one can only attempt to reduce the normal increases a bit by lowering LDL/triglycerides.

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Many of the articles I initially read said you could NOT lower your CAC score and that it would in face get higher because statins cause more calcification (which is actually good, as the calcified plaque is much less likely to break off and cause a clot than the "fatty plaque".

BUT, then I ran across this video from Cleveland Clinic which says if you lower your cholesterol aggressively, you can reduce the plaque (which, in theory, should lower your CAC since there's less plaque to calcify):
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Below are some related links about CAC scores and plaque:
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https://www.acc.org/latest-in-cardiology/articles/2021/11/10/19/50/the-effect-of-statin-therapy-on-the-progression-and-composition-of-coronary-atherosclerotic-plaque
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"Statin therapy is associated with atherosclerotic plaque transformation to higher calcium density, which is associated with slower plaque progression."
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793667/
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"CAC progression under statin therapy did not increase cardiovascular risk, although more supportive data are needed."
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https://health.clevelandclinic.org/can-statins-actually-reverse-plaque-buildup/
"Q: Can statins actually reverse plaque buildup?
---
A: Yes. There have been several clinical studies — many of them done here at Cleveland Clinic — that show statins can reverse plaque buildup.

If your LDL cholesterol is lowered below 70 mg/dL, you can even see a regression in the plaque by up to 24%. So having really a low LDL cholesterol level can help stabilize any plaque buildup you have, and prevent further plaque progression."
---
https://www.health.harvard.edu/heart-health/can-we-reduce-vascular-plaque-buildup
---
"Can you unclog your arteries, or reduce plaque buildup?
---
"Making plaque disappear is not possible, but we can shrink and stabilize it," says Dr. Cannon."

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@hikerguy62

Many of the articles I initially read said you could NOT lower your CAC score and that it would in face get higher because statins cause more calcification (which is actually good, as the calcified plaque is much less likely to break off and cause a clot than the "fatty plaque".

BUT, then I ran across this video from Cleveland Clinic which says if you lower your cholesterol aggressively, you can reduce the plaque (which, in theory, should lower your CAC since there's less plaque to calcify):
---


---
Below are some related links about CAC scores and plaque:
---
https://www.acc.org/latest-in-cardiology/articles/2021/11/10/19/50/the-effect-of-statin-therapy-on-the-progression-and-composition-of-coronary-atherosclerotic-plaque
---
"Statin therapy is associated with atherosclerotic plaque transformation to higher calcium density, which is associated with slower plaque progression."
---
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793667/
---
"CAC progression under statin therapy did not increase cardiovascular risk, although more supportive data are needed."
---
https://health.clevelandclinic.org/can-statins-actually-reverse-plaque-buildup/
"Q: Can statins actually reverse plaque buildup?
---
A: Yes. There have been several clinical studies — many of them done here at Cleveland Clinic — that show statins can reverse plaque buildup.

If your LDL cholesterol is lowered below 70 mg/dL, you can even see a regression in the plaque by up to 24%. So having really a low LDL cholesterol level can help stabilize any plaque buildup you have, and prevent further plaque progression."
---
https://www.health.harvard.edu/heart-health/can-we-reduce-vascular-plaque-buildup
---
"Can you unclog your arteries, or reduce plaque buildup?
---
"Making plaque disappear is not possible, but we can shrink and stabilize it," says Dr. Cannon."

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Reducing plaque is obviously different from reducing calcified plaque - I have read for several years and have not heard of anyone reporting they have lowered their calcium scores.

Most in our position are on some form of statin to reduce LDL (most have seen massive decreases in LDL), and I take Vascepa which lowers triglycerides massively. Other than managing weight (related), blood pressure (related), exercising, and eating a healthy diet - not sure much else can be done.

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@mayoconnectuser1

Ah, got it - Ramipril is an ACE inhibitor. Which BP med did you use prior to Ramipril? I am assuming you have long had high blood pressure? And, yes, weight loss will affect - way to go!

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Ramipril not only reduces blood pressure, But according to the Bale-Doneen method it decreases inflammation in the arteriole wall.

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Doesn't anyone question WHY and HOW the calcium ended up there? And, no, it's NOT good to have calcium in your arteries. And NO it is not inevitable - I know several people in their 60s and 70s who have a O calcium artery score and do not take statins And yes, your calcium score CAN be reduced. Do you take calcium supplements? Do you think they magically go to your bones? I cannot give you medical advice but I would strongly advise you read about vitamin K2 and calcium and, if you are somewhat medically or scientifically savvy, look up the research on this in the National Library of Medicine (https://pubmed.ncbi.nlm.nih.gov/).

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@slynnb

Doesn't anyone question WHY and HOW the calcium ended up there? And, no, it's NOT good to have calcium in your arteries. And NO it is not inevitable - I know several people in their 60s and 70s who have a O calcium artery score and do not take statins And yes, your calcium score CAN be reduced. Do you take calcium supplements? Do you think they magically go to your bones? I cannot give you medical advice but I would strongly advise you read about vitamin K2 and calcium and, if you are somewhat medically or scientifically savvy, look up the research on this in the National Library of Medicine (https://pubmed.ncbi.nlm.nih.gov/).

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slynnb,

Well, I guess we need to find one person who has reduced their calcium score.

Please help us find one?

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@santafepete

Cleveland suggested I start with high dose, high potency statin therapy.
If that fails, then go to Ezetimbe.
If that fails, go to PCSK9 inhibitors by injection
If that fails, go to Bempedoic Acid.
But as far as I can calculate, if the relative risk reduction of successful statin treatment is near 30% for heart attack risk reduction, then the absolute for me would still be almost 10%---down from 14%. So what am I gaining for all that money and misery?
It seems to me that diet, exercise, aggressive A1C management will gain me more---and I am already completely off red meat for seven years---for which no cardiologist has given me the slightest credit and I doubt they are doing so themselves. I will talk to my Endo about it, but reading up on Ezetimbe already suggested that the stuff doesnt actually help with mortality rates, just numbers. I am NOT a doctor, so please make understand that these are just my opinions as a patient, and ultimately I have to make a plan specific to my health and desires. Like everything else in life, you pays your money and takes your chances. 🙂

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Can you please elaborate on what aggressive A1C looks like...thank you.

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I'm not a doctor, but I have 3 stents recently and a very high calcium score. IMHO stents are not pre-emptive and a calcium score is not the reason to get a stent. They are considered when you are having symptoms, such as, during normal activities tightness in the chest, bouts of lightheadedness, weakness, getting winded or out of breath easily or maybe a rapid heart rate. The only way I am aware of to know a % of how much an artery is blocked is with a catherization - go in and take a look. But again if you aren't feeling anything may not be needed. I had a very high calcium score about 4 years ago and was feeling fine for 3 1/2 years having changed my diet and taking Crestor, until I started to have issues when I was out for a hike or bike riding. My pulse would pound in my arms and neck when I was just getting started, which hadn't happened before. I had all the standard heart testing done previously and at the standard check up points and always results were good.

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@jjohn10

I'm not a doctor, but I have 3 stents recently and a very high calcium score. IMHO stents are not pre-emptive and a calcium score is not the reason to get a stent. They are considered when you are having symptoms, such as, during normal activities tightness in the chest, bouts of lightheadedness, weakness, getting winded or out of breath easily or maybe a rapid heart rate. The only way I am aware of to know a % of how much an artery is blocked is with a catherization - go in and take a look. But again if you aren't feeling anything may not be needed. I had a very high calcium score about 4 years ago and was feeling fine for 3 1/2 years having changed my diet and taking Crestor, until I started to have issues when I was out for a hike or bike riding. My pulse would pound in my arms and neck when I was just getting started, which hadn't happened before. I had all the standard heart testing done previously and at the standard check up points and always results were good.

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Hi jjohn10---what was your CAC score? It shows that even if someone has a clean bill of health---it just takes some symptoms to find out their is narrowing or full blockages. It sounds like your back on the mend to a full recovery...happy to hear that.

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@jasper1072

Hi jjohn10---what was your CAC score? It shows that even if someone has a clean bill of health---it just takes some symptoms to find out their is narrowing or full blockages. It sounds like your back on the mend to a full recovery...happy to hear that.

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Not sure exactly but somewhere around 1400. Cardiologist said one of the highest the has ever seen. I didn't feel any effects of this for 3 1/2 years, remained very active. Then I started to have some issues when I was hiking or biking, where I would have to stop and let my pounding pulse settle down right after I would get started. Because all previous tests found no issues the cardiologist said the only option left was to take a look with a cath. I ended up with 2 stents. I feel like with stents now I have less energy and get tired quicker when active. I do a lot less than I did a year ago.

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