1. < Heart & Blood Health

CAC score now what

Posted by conorder @conorder, Aug 23 10:18am

54 year old very active male. I exercise 20 plus hours a week. Mountain bike and lift weights. My diet is clean for the most part. I relax some on the weekend and enjoy wine and IPAs. I had a cardiac ct scan done due to some chest pains and my CAC score came back as 195. My cholesterol was always right around 200 or lower. I had a ldl of 111 but an Hdl of 75. I was always told that was good. I don’t like the idea of going on statins and I am not sure how to clean up my diet more than it already is, I really enjoy going out to eat but I only do it on weekends and am really strict during the week. This is really hitting me hard and am unsure what my life will be like after this diagnosis. Should I just go on statins and nothing changes? Looking for information from anyone with a similar situation.

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chrisaw | @chrisaw | Aug 25 4:14pm

There are some great responses here.

I fought against taking statins from age 40 to 54 and know many the arguments against them. At an annual exam in December 2021 my primary told me he would no longer be my doctor unless I start on statins. My wife is a family medicine MD who follows AMA and AHA guidelines with her patients, so I knew her opinion. History of heart disease and early death on both sides. I was 54 y.o. with 240 cholesterol and no symptoms, active, with a great diet and I decided to give in.

I commited to navigating through the potential side effects of statins.

We tweaked the dosage once and then added a second statin and then fast forward 2.5 years to now. There have been zero adverse side effects and m cholesterol is 100.

However, I did learn my CAC is 1,208 now.
Follow up tests came back with a normal echo and no blockages. The statins did their job.

Inflammation is the underlying enemy.

I think our best role is to look for ways to reduce inflammation and to slow or stop the progression of plaque build up.

Statins are a powerful anti-inflammatory and many of us don't have any struggles with them. If the upside potential outweighs the downside potential it may be worth a try. You're asking good questions.

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1 reply
conorder | @conorder | Aug 25 5:00pm
In reply to @jlharsh "@conorder I have genetically high cholesterol and have not been able to get it under control..." + (show)
@jlharsh

@conorder I have genetically high cholesterol and have not been able to get it under control until I found a doctor taking a comprehensive approach to figuring out “why”. I am learning everyone is different, and science is learning more literally every day. I’m not sure Google can catch up quickly or posters online understand it all. If there is a drug that will help me more than hurt me, I want to take it. If there is something I can do myself to make my body work more efficiently, I want to do that. Maybe it will help your doctor if they know your perspective. It sounds like you want to learn as much about what is happening in your body and what risk they cause, instead of the “spray and pray” approach of taking a drug to address an individual blood marker or test score. Kudos!

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Thank you

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conorder | @conorder | Aug 26 5:23am
In reply to @chrisaw "There are some great responses here. I fought against taking statins from age 40 to 54..." + (show)
@chrisaw

There are some great responses here.

I fought against taking statins from age 40 to 54 and know many the arguments against them. At an annual exam in December 2021 my primary told me he would no longer be my doctor unless I start on statins. My wife is a family medicine MD who follows AMA and AHA guidelines with her patients, so I knew her opinion. History of heart disease and early death on both sides. I was 54 y.o. with 240 cholesterol and no symptoms, active, with a great diet and I decided to give in.

I commited to navigating through the potential side effects of statins.

We tweaked the dosage once and then added a second statin and then fast forward 2.5 years to now. There have been zero adverse side effects and m cholesterol is 100.

However, I did learn my CAC is 1,208 now.
Follow up tests came back with a normal echo and no blockages. The statins did their job.

Inflammation is the underlying enemy.

I think our best role is to look for ways to reduce inflammation and to slow or stop the progression of plaque build up.

Statins are a powerful anti-inflammatory and many of us don't have any struggles with them. If the upside potential outweighs the downside potential it may be worth a try. You're asking good questions.

Jump to this post

Thank you for the information

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bitsygirl | @bitsygirl | Aug 26 2:25pm

I received a shockingly high CAC score despite what seemed like a very healthy lifestyle and diet. Long story short and based on your description, in addition to statins I'd suggest looking into other possible lifestyle factors that may be going under the radar. I'd suggest learning about/monitoring your insulin sensitivity, blood pressure, consumption of saturated fat and lipoprotein(a). I read "Beat the Heart Attack Gene" and it was helpful as a starting point to learn more about it.

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1 reply
chrisaw | @chrisaw | Aug 27 9:35am
In reply to @bitsygirl "I received a shockingly high CAC score despite what seemed like a very healthy lifestyle and..." + (show)
@bitsygirl

I received a shockingly high CAC score despite what seemed like a very healthy lifestyle and diet. Long story short and based on your description, in addition to statins I'd suggest looking into other possible lifestyle factors that may be going under the radar. I'd suggest learning about/monitoring your insulin sensitivity, blood pressure, consumption of saturated fat and lipoprotein(a). I read "Beat the Heart Attack Gene" and it was helpful as a starting point to learn more about it.

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I can not agree more. That book is extremely helpful. It gave us some screening tools for my adult children so they can be out in front of this.

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bobbyo1 | @bobbyo1 | Aug 28 3:20pm

Hi There

You just described me exactly and I am wondering the same thing. I am giving a very low dose of statins a try for 1 year to see how I respond. love food and a little tequila on the weekends but have committed to less then 15 grams of saturated fat per day ( eliminated cheese ) Took a little getting used to but now it is easy. Eating a clean healthy diet with fresh organic foods and quality low fat protein is very enjoyable and I feel great. Bottom line the CAC score is only one piece to the puzzle. Enjoy a healthy lifestyle and enjoy life !

Best

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cattknap | @cattknap | Aug 29 12:59pm

I am in the 82nd percentile for CAC which is calcium on the outside of the heart. I wore a heart monitor for 3 weeks and my heart doctor said that my heart was in good condition. I have had high blood calcium for years. Daily I eat 1/2 cup of organic whole fat A2-A2 plain grass fed yogurt and take no calcium supplement. My daily vitamin supplies 5% of the daily requirement. I have Celiac disease so I need those probiotics.
I hike up and down hills 4 times a week 2.5 to 3.5 miles each time. I have severe osteoporosis and because of my heart calcium I cannot take the bone building drugs that I should be on.
I am in line to see a specialist for my osteoporosis. They tested my para-thyroid and it was normal. My blood work is all perfect as is my blood pressure. I have normal blood sugar (85). I am 73, 5’8” and weigh 148. I eat a perfect diet, lots of greens, protein, no sweets, etc.
Anyone else have high blood calcium or words of wisdom for me?

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1 reply
tim1028 | @tim1028 | Sep 9 4:25pm
In reply to @mayoconnectuser1 "concorder, This is the aha moment that many of us have as we age ... we..." + (show)
@mayoconnectuser1

concorder,

This is the aha moment that many of us have as we age ... we find out our genetic predispositions become clear ... even if we have been careful in our life habits.

What tests?
- stress test with echo is appropriate
- advanced lipids test is appropriate
- nuclear stress test might be appropriate
- catheterization if you are symptomatic
- heart ct was appropriate due to chest pain
- do you ejection fraction data?

The concerning part of your post is that you have had some chest pain - on this site many have high and very high CAC - but, are asymptomatic. Some are asymptomatic and end up finding high blockages. Some are symptomatic, but don't have significant blockages.

Ex: On a whim my wife and I got CAC tests around age 65, her - zero, mine 1350. I had started statins due to age and elevated (treated) blood pressure about a year earlier. Asymptomatic. All the non-invasive tests no issues. Stress test very good. CT but calcium tended to reflect so much had to tell, but clearly lots of it. Next CAC 2500. Still no symptoms. Stress test with echo pretty darn good with good pumping, etc. Several vacations with LOTS of hill walking far tougher than the stress tests, Colorado high altitude hiking. Still no symptoms. HDL low 50s (have always been low 50s, even when young while working out in military), LDL 50ish, triglycerides 50ish. Advanced lipids all good. No other health issues. I take a bp med (115/75), atorvastatin 40 mg, 81 mg aspirin (have for 30 years), Vascepa 2 grams per day.

Will have nuclear stress test in October. Cardiologist and others mention positive remodeling likely, so heart over time may have increased size of arteries to account for blockages.

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Some people also have collateral arteries, which go around blockages in much the same way road detours work.

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1 reply
bitsygirl | @bitsygirl | Sep 9 4:40pm
In reply to @tim1028 "Some people also have collateral arteries, which go around blockages in much the same way road..." + (show)
@tim1028

Some people also have collateral arteries, which go around blockages in much the same way road detours work.

Jump to this post

I've heard of this but never really looked into it. Have you run across anything that describes it well?

Wouldn't it be great if these could be identified by some imaging. Do they show up on a traditional angiogram? Would be some peace of mind to know that these are in place in your heart. (I know you'd never do an angiogram just for this, but I wonder if they show up.)

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