Coronary calcium score: what it means and how to interpret your results (AMA #5)
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- čas přidán 19. 05. 2024
- Original release date: 4/22/19
This AMA Clip is a segment pulled from an "Ask Me Anything" episode of The Drive titled: #50 - AMA #5: calcium scores, centenarian olympics, exercise, muscle glycogen, keto, and more
Show notes page: peterattiamd.com/ama05/
About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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I am 81 I had a calcium score of 1200 three years ago. My brother who is 60 just had one done and he was 1100 and my buddy who is 78 had a score of 2200. My buddy and my brother both had cardiac workups and the cardiologist told both of them they were fine and don't worry about it. My thought was nobody lives forever so I did not get the work up. I figured what the hell are they going to do? A bypass, a stent? I never have any chest pain or shortness of breath. Having a heart attack in your 80s and dying is not the worst thing. Going into a nursing home at 100K a year and having some 20-year-old nurses aid wipe your butt because you are incontinent is much worse.
Love your attitude. I think you're going to live a lot longer with that outlook!
Ur reasoning and judgement is soothing to me as i was recently diagnosed with CAD and calcium score of 50 at 55 . Not sure where my path will lead by my Lord 🙏
My friend got his to zero in 1 years using vitamin K2.
@@norsangkelsang7939WHAT?!!! That's amazing! Are you sure? I heard K² is very beneficial but that's crazy!
how high was he to start with? @@norsangkelsang7939
I swear the more videos I watch on this subject the more I come to the conclusion that There is no straight forward test or way to predict any of it
I found Dr Attia a few weeks ago and he has utterly change my thinking for the better and healthy life.
I'm so glad that I watched this, Peter put this in perspective for me. Thanks Peter!
An excellent video that answered many questions I've had. Thank you!
I have had a ton of assaults to my arteries. I am a 75 year old man who has a strong family history of CVD. My grandfather, father, and brothers have had terrible problems. I do not take a statin. My CAC score is 1400 but I have never had a problem and feel great. My ECG still has all the peaks in the right places. I assume that my good fortune is due to the fact that for 51 years (I read Cooper's book) I have always worked out 5 times a week. Since getting my CAC score 4 years ago I have begun fasting and eating fewer carbs. I have brought my Tg/HDL ratio down to 1.1 (.49 in Canadian/European units.) I hope this lowers my need for calcium patches.
How is your CAC score now?
1
He might be dead
Did you have high cholesterol?
Thank you for clarifying this
Thank you both Awesome Brilliant Health tips
Thank you for this informative discussion! Question: I read recently that near starvation diet (as seen in WW1 autopsies), and in another study- alcohol consumption were the ways to reduce coronary plaque and LP(a), respectively. Do you agree?
With a score of 55 I thought I was good to go. Glad I watched this video.
Dr Ross Walker (Australian cardiologist)says that if you're over 60 years, and if you score anything under 100 CCA, you should not be on any Statin drugs.
Great knowledge
Great discussion. But is calcium really only backward looking? It seems that calcium (hard and dense) adhering to tissue that is meant to flex, would inhibit that flexibility over time.
Very good summary. A score of 0 doesn't mean no calcium and no risk of a coronary event, just no detected calcification, there could be very small spots in the heart or other parts of the body as he stated.
CAC is a measure of risk, a 0 is the lowest possible risk of a coronary event in the next 5-10 years. If the doctor is to be believed then having calcium in your arteries means you’ve already had an event and calcium buildup is the end of that coronary episode. He also said age is a big factor, the example he used was the 60ish with 0 CAC but high LDL may have a system resistant to coronary disease or has successfully bio hacked themselves. Ultimately it’s up to the individual to reduce risk as low as possible and getting second opinions is most definitely important.
@@andrewrivera4029 It looks as if Vitamin K2 may have a protective effect for arteries, if the studies are to be believed, it supposedly moves calcium in the bloodstream to bones, and helps prevent it settling in the artery walls with cholesterol deposits. This matches up with the Japanese diet of eating Natto, fermented young soybeans, which has high levels of K2 apparently, and their relatively low incidence of heart disease (among other dietary factors like seafood (taurine) and smaller meals).
I'm a lean mass hyperresponder, and trying to get into Dave Feldman's study. I have a total cholesterol of 403, LDL 289, but HDL 119, triglycerides 35. BMI 20. I just had a Calcium ct score of 278. My inflammatory markers are all quite low, and my fasting insulin is 4.2. First of all, I'm not going to worry about anything, and live my life to the fullest at 72. Second, this plaque has probably been building up for decades, and I've only been on keto for 2 years. I view each test as one piece of the puzzle and nothing more.
Have a look at Prof. Robert Lustig, endocrinologist at USF, particularly his discussions about cholesterol. He suggests that determination of particle size of LDLs is important to establish the ratio of the dangerous small dense LDLs vs buoyant LDLs.
@@geoffharrower2845 Dr Lustig has amazing credentials. But I think you've misinterpted his point. Yes, some LDL particles are more deleterious to health than others, but for the layman, as in us, ALL LDL particles are atherogenic. So if you lower your LDL-C, regardless of particle size, you've effectively lowered your risk. Now if, and only if that becomes complicated and stubborn to achieve even with pharmacology, then you can begin to dissect particle size in order to find a more targeted personal therapy. We have to be careful of those in the keto/high fat camp that like to parse false complancies by defending things like high HDL, which is not protective of CVD, and low triglyceride levels somehow off setting the risk high LDL-C.
@geoffharrower2845 . . I 0:16 8
I please stop the keto/carnivore diet on that CAC score. It's not worth it. Lower the LDL to 60.
I’ve embraced A Ketovore lifestyle (Carnivore with a random salad), walk/exercise 6 days a week, take K2 & D3 daily… I’m canceling my CAC scan. Whatever is done, I can’t do anything about.
When I was 57 I had a CAC score of 57. That was a wake up call. I am following Peter's advice and treating aggressively to get my ApoB under 40 (LDL under 55). So far I have lowered LDL from 146 to 85 (ApoB from 119 to 71) without drugs. Next is finding the drug mix that gets me the rest of the way with the least side effects. A guy I work with did iron man competitions regularly and dropped dead from a heart attack during his last one at the age of 43. You can have very severe heart disease with no symptoms until that fatal first heart attack, but this can be wholly avoided by aggressive preventative care early enough.
There are lots of marathon runners that drop dead frequently. That's why cardio of frowned upon now by some cardiologist. The recommendations are now HiiT walking and cycling
What did you do to lower your ApoB without medication?
Thank you for mentioning a CT angiogram. I am going to suggest that to my doctor. I have a high CAD (plaque is located in my main artery/widows maker) score especially taking into consideration my great overall health, eat healthy, good blood work (except for high LDL and high total cholesterol), have no dense small particles and some big buoyant particles, not overweight, low blood pressure, workout regularly, etc. It's very confusing to say the least especially when I have taken care of my body for over 15 years. I am currently 58.
What's your lipoprotein (a) level tho?
Do you have FH? similar story as yours pretty healthy, not overweight, low blood pressure, homocysteine good, so are the triglycerides, but cholesterol at 430 LDL!
I got last spring Angina symptoms, and was ordered a TC scan ( 58Y male). Have been past decades living a pretty healy lifestyle, expect for a stressful job. My calcium score was 0, but the bad news, my aorta is enlarged. The strange thing is i have OK cholesterol values, low blood pressure, ok physical condition, ok bmi...dont get this, not much i can do improve the situation and why is it enlarged in the first place. My symptoms was during strainfull physical activities got pain in the lower jaw, and if rest, the pain goes away. I also had for a few years kind of voice issues, without any obvious reason. This was considered angina symptoms, but in reality related to enlarged aorta. A good thing i got the symptoms, now i at least know.
I am 75 and recently had a CAC with a score of 538, followed up with a pharmacological nuclear stress test that I passed. I'm on two statins, aspirin, and have my LDL down to 49. I was very concerned about this as most of the calcium is in my LADA. Thought I was going to drop dead any minute. Well, I feel a bit better now and just going to get on with life and add more exercise although arthritis is pretty bad. Guess I am lucky I made it to 75. Thank Dr. Attia for the information. I am diabetic too. On Farxiga and Trulicity which has my A1C down to 5.4.
I’m diabetic thank God off of Med BEC of Proper human diet Low carb, no sugar ,organic Pasteur raised beef,chicken,no processed food ,I learned that standard diabetic care is not useful, DO THE OPPOSITE, I do fasting and Omad . And still going there, take a listen to Dr.Ken Berry for more sound health advise.
I'm 70 and my score was 32. I have eaten carnivore for 4 years. If saturated fat is the cause of heart disease, then the test would have shown it. Please research keto/carnivore way of eating. Reduce sugar consumption and then cut out all sugar, carbs and seed oils like canola oil. Here is a video by Dr Ken Berry...czcams.com/video/ZqtXTP2BDgc/video.html
Look into oxalate toxicity. Avoiding high oxalate foods might be a good thing. There is some evidence that calcium oxalate causes inflammation in the blood vessels.
I just had my CAC score done three days ago. Score = 305. I'm nearly 76.
Have you established the volume of small dense LDLs vs buoyant LDLs
Your arthritis is pretty bad could be because of the statins your Dr prescribed.
It seems cac scores are used to stress the patients into having MI.
1:35 at least among the people I'm watching, the CAC is just a card they pull when their doc insists on a statin etc because of high LDL despite an overall context of low inflammation, high HDL, low TG, etc.
Neither I nor anyone whose ideas I consider useful or reliable would claim CAC=0 means nothing matters, but that it adds the the weight of evidence against using LDL in a vacuum as the only CV risk marker.
my lipo B is very high, overall cholesterol very high, CAC score is zero. NEVER will I take a statin. Sick of the statin push
50 years old with Ca score of 28. Very concerned now! Didn’t expect to be having problems like this yet.
Hang tough Bi0lizard. I was over 500 at 50. I'm 68 now, with a score of 2,100. But I have no blockages. My angiogram is clear.
@@ZonaJimhave you been taking statins since you had CAC when you were 50?
I’m 54 and just got a score of 246 despite good lipid (APO B 78, AP a 64) and low inflammation and low insulin resistance score and slim. My doctor thinks it’s because of prednisone use when I was a child (autoimmune disease) and recommended me to take statins. But I’m hesitant.
@@12yukos I started on statins in my 40's.
@@ZonaJimThat is awesome, your annual progression rate of calcification is 5%. Did you change anything after receiving your first score of 500? Diet, exercise supplements? Great job
Thanks for all you do, Peter. LOVED your book!
79 year old father has a score of 518. PA wants to put him on a statin. LDL 132, HDL 49, Triglycerides 80. He went to doctor because of lingering cough and they discovered mild scaring of the lungs. I am wondering if scaring on lungs was from Covid last year? Smoked for 6 years but quit in 1967. Also, rides his bike 50 miles and climbs 8,000 foot mountain peaks, no problem. The whole situation is confusing and trying to figure out the best answer. Any input would be appreciated.
Im pretty much on teh same boat. i had a score of 400, I have a pretty variable cholesterol, which curiously seems to increase when I lower my thyroid medication. It also seems teh plaque is concentrated on one artery. However Im not overweight, I do 20 miles in a stationary bike every day and 40 miles every other day. Im also a bit confused .
I wish I could have seen this video 10 years ago when I got a CAC score of 1188 and was sure I was going to die any day.
I just racked up an 1124. Be my spirit brother/sister?
@@Whineboy Brother. I could tell you my protocol, but I have no idea what, if anything, was helpful.
@@gabymalembe
I've got my Calcium score it is 676 and I'm scared to death
I'm 62 years old pretty active woman with high cholesterol 367 and ldl 250 over 2 years on keto
Statins?
Any sugestions from your experience with doctors?
Thanks in advance
@@barbarapecka4935 Ford Brewer, on his youTube channel, recommends statins (as did every cardiologist I’ve seen), exercise, weight loss, vitamins D3 and K2, and optimizing blood sugar.
If you want to optimize your blood sugar, I found that a continuous glucose monitor was very helpful, because in 2 weeks I was very surprised at which foods cause my glucose to spike and which ones don’t.
Anyone listening to this, get your pencil out and take notes. Watched this two years ago, rewatched today with pencil in hand.
I believe that taking Vitamin K2 (MK7 form) is helpful as a preventative for Coronary calcium.
Have ben doing keto for 8 years now, and got a ct scan for a CAC score 3 years ago, it was 0. Prior to Keto, i ate almost soley a carb diet. Had eczema, pre diabetes, arthritis, high blood pressure, neuropathy, and depression. All of it disappeared within three months of a ketogenic diet.
I’m 60 Keto/OMAD just had my first CAC of 1232! CVD runs in my family. So I’m devouring all I can. Asymptomatic, in the best health of my life. Weights, tennis cardio 3X per week. Waiting to see a cardiologist
Hi. I've got my Calcium score. It's 676. I'm scared to death .
I'm 62 years old pretty active woman with high cholesterol 330 and ldl 220. Over 2 years on keto .
Did you see your cardiologist?
Any sugestions?
Any update from cardiologist you'd wish to share, as to how to reduce the risk from here?
Watch Dr. Ken Berry he has a CAC video and has a personal predictor form there you can fill up and will personally tell you what it means. Let me know what your cardiologist say. I will see mine this Thursday too good luck to us. Let’s talk about this matter and share what our cardiologist says.
@@barbarapecka4935 watch Dr Berry re keto people have high ldl cholesterol,I’m on keto same issues
I thought CAC was a scale from 0 - 300 ? what did your cardiologist say ?
My coronary calcium score last year was 441. However, the cardiologist didn’t seem concerned since my lipid numbers were normal and I am on Atorvastatin. I also have moderate Aortic Stenosis.
So the CAC score is useful to know if it is consistent with others in your age group.. but it seems very non-linear:
for example the 50% for
45-49 is 3
50-55 is 15
55-59 is 48
Exercise in highly trained athletes appear to increase the score.
We need a video for the Attia Curry?
Dr Ford Brewer has some very good vids on this subject. Calcified plaque is far safer than the soft version.
CAC measure ONLY hard plaque NOT the dangerous soft plaque! CIMT is better dummies!
@@jerseytony1 It is still valuable because its quick, easy and cheap and tells you you have atherosclerosis and need to investigate more deeply. CIMT's , if done well, are more useful. Dummies
@@jerseytony1 what is the soft plaque and what causes it?
No plaque is “safer”.
13:15 starts the point of CAC for low/med/high intensity exercise. Hold out: he makes his point a few minutes later. Focus, bro 😎
Took the interviewer for ever to get to his point after qualifying it and then changing the equation multiple times. I'm not sure it had much validity since 1. he didn't define the exercise levels 2. No lipid #s were associated 3 no cac scores were cited. It sounded like he just wanted to sound as intelligent the Dr.
I turn 50 next week and just got a score of 707. Massive hereditary history. I'm 5'8" and 141 lbs. Exercise daily and eat pretty well. Cardiologist had me do a treadmill and I hit 170bmp with zero issues and ran for 10 minutes. Also did an echocardiogram and everything looked absolutely perfect. I was on simvastatin (20mg) for the last 8 years so he switched me to 40mg of Crestor and a baby aspirin. I regularly get my heart rate in the 150s when I'm exercising and have never had any symptoms. I dialed in my diet after this score and have lowered my daily saturated fat content to roughly 6 to 8 grams a day. Also have gone almost mainly mediterranean.
All good steps that you have taken, but a score of 707 indicates very high risk of future major cardiac events. If I were you, I would take measures to get your LDL below 50 so you stop any progression of current plaques and regress current plaques. PCSK9 inhibitors can significantly slow calcification and maybe reverse it.
@@dgreen1064 In 3 months of switching to Crestor I was able to bring my LDL down from 95 to 56. I’m hoping to be under 50 at my next test in a few months.
How is the med diet how's the food any good
@@dgreen1064 Hi, would you mind sharing the data on PCSK9 inhibitors? thanks
Several of my MD's (I see a pulmonologist, hematologist, gastroenterologist. cardiologist, and a GP). There is some disagreement on the significance of blood lipids. Obviously there are factors we don't know about and money has tainted medicine.
I just started the carnivore diet to try and get relief from autoimmune conditions as I have run out of options. I hope it will help with my weight but time will tell.
I asked my physician for a referral to get a calcium score. She she said wait until you have an event that would deem it necessary. Guess I'll be paying for one out of pocket so much for healthcare premiums.
Insurance doesn’t pay for it anyway. Call around. In my town, prices range from $150-$400.
I paid out of pocket $100, best I ever spent!
We just had ours done at a cost of $99 each. (In Pennsylvania)
I was able to have my CAC done, paid for via insurance, based on the fact that my mother died a few years ago from complications or arteriosclerosis, I have a family history of CVD on both sides, I'm 52 and menopausal, and my cholesterol is high (although I've gotten is down to 232 overall). I'm so glad I did. My CAC was 601, and I've been going through the evaluation process since that finding that information out in September. I have a stress echo on Tuesday, my standard echo found mild diastolic dysfunction, but nothing to worry about according to the Stanford cardiologist. I was also recently diagnosed with HBP after a lifetime of having low blood pressure, but my medical team and I are fairly certain that it's due to a different medication which I have since stopped.
My doctor told me I didn’t need a new CAC because I had an event for years earlier after the first CAC. 🤷🏻♂️
If heart attacks/heart problems kill so many people, why is it that the only thing a general physician knows is "Cholesterol scores high...take statins"? I had to demand a CAC because my gen Practitioner used the "cholestorol high..must prescribe statins" mantra. There's growing numbers of studies questioning the blanket prescribing of statins. Why don't doctors know better how to assess coronary health?
Can they analyze a sample of artery plaque from a cadaver? I think calcium oxalate in my blood is increasing my CAC.
Would have loved to hear more about treatment for high CAC scores..
Listen to Dr. Ken Berry proper human diet.
According to this Dr. It’s statins statins statins!
@@carmenross1077 Berry is a quack.
@@bettywhill Exactly! Doctors with logical brains who approach and interepret the science properly, and the studies properly, all know that statins work.
@@napnap609 I avoid the CZcams docs who have a cure for everything under the sun. Sometimes they may be spot on, other times giving dangerous advice. How does a layperson know one from the other? Stick with the PhD's and MD specialists in a particular field, in my opinion.
Like Norm whose comment follows mine, I'm also 81. My question is if my cardiologist correctly diagnosed me with FH at age 70, in part because my LDL at that time was 210, could my LDL have been half that level anywhere between age 40-60? Thank you!
I've been following the LDL issue for years and there are brilliant people on both sides of the issue and unfortunately no conclusive evidence either way. The upcoming 2 year study by Dave Feldman will hopefully finally show whether or not lmhrs are protected from high LDL-P as he and many others suggest. I think the one thing all agree on is that insulin resistance is a huge contributor of heart disease and everyone should be addressing that. I'm certain I had the beginnings of it as early as in my 30s but it went undected because my fasting blood glucose was always "in range". Early detection is paramount and requires more than just a fasting glucose test.
Doctors always says you’re fine re your blood glucose well check it next year even though you’re in borderline. Just learned from my experience.
What other tests do you recommend?
did you have high cholesterol?
Any tips on how you reversed it?
@carmenross1077 if your blood glucose is borderline or HbA1c is borderline, ask for a Fasting Insulin. A high insulin might be causing as much a problem as glucose.
Could a bad case of Covid-19 cause damage to the heart that would increase CAC score?
I’ve been keto for five years and just got my first CAC score = 368. I wish I had known what it was five years ago. Hoping next year it’s lower.
You cannot reduce your number. Regardless of what anyone says. However, you can slow/prevent any new plaque from forming in new areas.
The Dr asserts CAC = not 0 is abnormal, period. Whereas the published tables show ranges to age for CAC scores with more latitude.
@@HellcatManual2023
Oh really? Maybe you should watch this...
czcams.com/video/ysifMKWKZLY/video.html
@@njsongwriter
Do the research and you’ll realize it’s just not possible. I wish it were. Dr. Agatston would be the one person who truly knows whether it’s possible, and he says it’s not.
@@HellcatManual2023 So how do explain Ford Brewer’s own personal case as well as cases of his patients and patients and others lowering CAC scores?
How did you get insurance approval for a coronary CTA? No way they would cover in the absence of symptoms or abN stress test (which they also wouldn’t cover solely based on abN lipid panel)?
Please discuss Kraft assay test
I watched this and really gained no more insights on how to chart an action plan to my high CAC score.
WFPB
Oh I love the way he put it where you live in a bad neighborhood but you got a pitbull that’s fighting it off 😊
It is interesting to read all the comments from older men who exercise. I have been involved with fitness and health since I was a kid and made a career of it. I'm now 71 and still a regular strength trainer and cardio guy. I'm currently on no medications but my doctor wants me to start a low dose statin. My triglycerides are low but my LDL is always around 110 to 120 and my total is around 205. My HDL is also high around 65. I decided to do a Calcium scan to see what was up before I agreed to go on the Statin. There is little or no heart disease in my family but my father has some mild strokes at 92 and lived to 95. My Calcium score came back at 97. I have heard from no one about my results? I found them on my patient portal. I went to see a cardiologist also before the Calcium test. Nothing from my GP or my cardiologist? Another interesting issue in my mind is my heart rate. My normal heart rate is around 75 to 80. My exercise rate can reach 160. I'm a relatively small guy 5'4" 128lb. by no means overweight in fact I suffer from the other problem of keeping weight on. I careful about my diet but I have to get enough calories or I will blow away. Can't seem to get any good answers from my doctors on anything.
CAC of 97 at age 71 is excellent. CAC is thought to represent about 30% of total plaque. Some think that in highly trained endurance athletes that the calcified plaque represents all of the plaque, which was the case for me, 30 years of high level triathlon training and racing, at age 63, CAC 235, CT Angiogram showed no soft plaque. Look into APO b levels. My cardiologist suggests that low dose statins are safer than baby aspirin and there is some thought that low dose statins are the way to go as part of a diet and exercise program to lower APO b.
Thanks. That is helpful. Probably will start the low dose staten at my next yearly physical. I can’t adjust my diet anymore as my weight keeps dropping and I need to gain some back or I will blow away.!
At 35 I broke my rib doing Jiu Jitsu - and discovered after a CT scan that I had Plaque. After a cardio workup, I have LAD plaque and a score of 55. I am glad I found this as I have managed well.
Hey man can we stay in touch? Got a similiar score at the same age and I am terrified. What did your doctor tell you about risk going forward? My score was 10 but pretty sure it’s all bad at our age irregadless of the score.
@@AgrippaMaxentius yeah I get checked every year and really watch my lifestyle. I drove myself crazy worrying about it, but essentially cannot do much besides manage and constantly monitor.
@@AN-jz3px Man I am wishing you the best. Did the Doc give any positive feedback? Ive read all of the studies and it seems we are for sure more likely to have Cardio issues but seems to be a much more case by case basis. Id love to see a study with folks with our scores that turned their lifestyles around.
@@AgrippaMaxentius I've always had a good lifestyle - am 6'1" 200 lbs and have been wrestling / doing mma / jiu jitsu all my life. Don't smoke, don't drink. Just genetics!! I wouldn't worry about it, just live your life and monitor.
can you take d3 and k2 with a statin ? if so, what dosage do you suggest for d3 and k2 ?
Professor Robert Lustig, endocrinologist at USF , maintains the statins have very minimal effect unless you’ve already had a cardiac event
@@geoffharrower2845 Lustig is a charlatan
According to doctors, calcium increasing is bad, unless you are on statins, then it is good
Exactly...just push those statins!
Would you please post the scientific studies that prove that calcium increase while on statins is a good thing? Would really like to read those. Thanks!
I read somewhere that the statin will harden some of the soft plaque which in turn puts your calcium score up. A calcium score does not measure soft plaque.
Should I take a statin if my cholesterol is normal and I’m not diabetic, and I have good blood pressure, just because my cac score is 913?
Let me know if you ended up taking statins. I’m on he same boat.
In another video Petter explains that a low dose of 5mg of Rosuvastatin gives you 85% of the benefits of statins. Might want to start there and see if you get any side effects.
Hdl 46. Ldl 230. Total 281. Bmi 25 Cta. Cac 0. 5y on K2 but no Cta before K2….🤷♀️
I'm getting a pit bull.
What do the different scores on the arteries mean? Some are zero.
Very interesting. I was a competative cyclist for about 10 years, I have both a Incomplete RBBB and a resent CAC of 161 now at at 54. Still have above average VO2 max and a low resting heart rate. Was on the fence about statins, as my numbers are not that bad, still below the threshold for therapy. I eat a low-carb diet, but think it's time to agressively attack APOB.
You should be on a statin with that CAC
I have a CAC score of 23 , but they said I have calcification on ascending aorta. GP Recommended Lipitor. Thoughts?
That was my exact scenario. Lipitor can lower inflammation, but it also prevents absorptionof K-2, which actually helps de-calcify, so I take Lipitor once a week, but I'd like to get off of it completely
Pitbulls relieve my anxiety. So sweet!
Can taking OTC TUMS raise CAC score ?
"You just like saying CAC." 😂
The lady with a wonky lipid numbers is a lean mass hyper responder.
Wtf is that lmao
Dr Ford Brewer prefers CITM and inflammation test
The only problem is an inflammation test is of no help if there are other sources of inflammation in the body. I have skin cancer that will give me elevated levels on inflammation tests.
You mean a CIMT
Up until age 42, I was a metabolic train wreck. Obese, (waist size 42), high BP, pre-diabetic with borderline high triglycerides. In the last decade, I dropped 80 lbs, A1c has leveled off to 5.5, fasting insulin is 5, and my trig/hdl ratio is 0.76 now. My total chol and LDL have gone way up, but I've had lipoprotein particle testing that showed I have much more of the large, buoyant LDL and my Lp(a) is
I wouldn't take a statin and might contact Dr Ovadia for his advice. Read his book.
LDL particle count doesn’t really mean much at all. Even some iDLs can penetrate the intima. All ApoB particles are athogenic according to the science literature - thinking that only the small oxidated/glycated LDLs are dangerous is a myth.
When you're in the 90th percentile, you need to be on a statin which is probably why the doctor called it in without hesitation. And, a CAC test in 1 year may not provide much more useful info, since you're already in a range that indicates aggressive risk factor modification; not just lifestyle but pharmacological as well. CAC tests aren't usually repeated because they only cause more unnecessary alarm in patients because the score will most certainly be higher than your first test; which if on a statin a higher score means more stable, if you're not on a statin and your score is higher than the initial test, then you're just rolling the dice. But of course to each his or her own, we all gotta do what we feel is best for ourselves.
@@njsongwriter Satins work.
and how does Calcium channel blockers complicate things?
Nice
I’m in the camp that doesn’t care what the Total or LDL is as long as you eat very low carbohydrates and have low triglycerides and high HDL. If they could make a pill for triglycerides and HDL they would and push it on us. You can lower triglycerides fast if you cut out the carbs and possibly alcohol. HDL will take a bit longer but will go up if you are active and lift some heavy things. I expect my CAC score next week. If more than zero, it’s because of my old lifestyle. I’m 68 and have no history of heart disease in me or the family. I’m not going to take a statin, period. I’ll just continue with mostly red meat and fish, high fat yogurts, hard cheeses, berries, good fats like butter, lard, olive oil, avocado oil and zero grains and processed vegetable seed oils.
Hello. What was your last cac score?? Are you still doing keto?
I'm of the same conviction as you. I'm 75 did keto bfor two years and now on carnivore. I'm nearly 76. My CAC is 305.
@@bostonjackson9384 cac was 200 something. Last week my other numbers were:
Total cholesterol. 282
LDL. 190
HDL. 79
Triglycerides. 57
VLDL. 13
I Went from 212 lbs to 170 and remain there now for about 18 months and feel better physically, mentally and emotionally. So good that I un-retired and now work 42 hours a week at a large hardware store, walking an average of 6500 steps a day there and getting to lift heavy things like sand, concrete, soil etc. I ride to work rain or shine on an electric bike, 5 miles one way. I have relaxed my sugar rules and now have a big bowl of ice cream every night. But that’s the only carbs I consume. My Total and LDL actually went down from 349 and 248 with the others staying the same. Of course the doctor and I don’t get along, we both are firmly convinced that each other is crazy. She works for a large medical group in the state and she flat out told me that she has to push the statins for legal liability reasons for her AND the medical group. Long answer to your question, I am not in ketosis anymore. At least I can attest to its effectiveness and will never forget lessons learned…….. throw out ALL seed oils, don’t eat fruit, bread, pasta and rice. Eat 2 meals a day, don’t drink or count calories, eat till you are full, don’t eat if you are not hungry, eat fatty meats, fish and lots of eggs.
I was disappointed by my CAC score but I do blame my standard American diet from decades past. I expect a repeat CAC will remain same or perhaps go down a bit as time goes by.
@@MarkSmith-js2pu Did you have a previous CAC score or was the 200 your one and only score ever sat through? Do you take vitamin k2 supplements?
Please discuss CIMT
Watch Dr Ford Brewer & cardio Risk
Im 47 and have a score of 1.5 My cholesterol is around 280 with my LDL being around 180 and HDL of 50.
Does this seem alarming?
I was told that my diet isn't the problem since everything else was great and I have fam history of high cholesterol.
IDK, what are your triglycerides? If they're in the same range as HDL your risk is probably low.
@@thefisherking78 67 for triglycerides
I remember hearing about a meta analysis a while back that showed a total cholesterol up to 280 was the safest group to be in. Cant remember the lower floor to the range, but I recall it being in the upper 100s
@@beezowdoodoozoppitybopbopb9488 🤙🏼
My calcium score four days ago was 1100. I'm 70 years old and work at McDonald's to supplement my Social Security. Probably not a wise choice...
This interview seems more geared to professionals
Had a ct with cac of zero. Three months later still presented with chest angina cta cac zero no known issues still have angina no dr seems concerned just tell me how my anxiety is triggering all my angina. Got my bp in check but still concerned about chest pain. Any help would be appreciated
Zero cac means you have not had an incursion/event yet but CAC does not pick up on soft plaque. Check you blood work.
By cta do you mean CT angiogram with IV contrast?
CT WITHOUT X2
CT WITH CONTRAST
Anyone knows the highest number of a CT calcium score?
Evidently statin didn’t work for that patient whose calcium score kept going up the the 20 years.
But Dr Attia explained that since statins stabilize plaque your CAC score will usually go up on statins. It is not calcified plaque that is the issue, the calcium represents a stable bandaid in a damaged artery. Its the liquid soft plaque that is the killer, and statins will calcify the softer plaques.
Statins increase calcification
@@msantello1 Is it the drug that does that, or is it the body that does that once you've lowered your cholesterol enough? In other words, would a diet and lifestyle that consistently delivers a low cholesterol/ low LDL do the same thing?
@@Joseph1NJ My understanding is that while your body will calcify plaque on its own, as the good, non-oxidized LDL is designed to do, my Dr and other sources say the statins amp that process up in a big way...if you have a bunch of unstabilized plaque in your arteries. Dr. Ford Brewer said in one of his many videos that he got to have a look/see at the inside of an diseased artery in a cadaver, and he said it was like "pimples on a teenager's face." We have been led to believe that when you have a cardiac event is is the calcified plaque that has dislodged and caused the stroke or CI, but its not. Its the soft, infected plaque that has erupted into the blood stream, and when it interacts with blood forms a clot...and then boom. The bottom line is that this process is not cholesterol driven as a whole, but thought to be more about a body-wide biochemistry of insulin resistance that oxidized the LDL particles in the first place, making them highly inflammatory. And when these kinds of LDL particles invade a crack or fissure in an artery, that inflammatory stuff gets into the under layers, and your off to the races so to speak. Some, not all statins, can have more of an anti inflammatory & plaque calcifying effect, thus making these soft lesions in "safer" and less inflamed. Crestor is the best for this I have heard. And yes, diet, exercise, supplements - there are many other ways to address this issue without stains and their terrible side effects. But again, the actual cholesterol particle #'s are not the whole story. How LDL is getting oxidized is. Cheers.
Statins also reduce inflammation. Low carb diets also reduce inflammation. It is possible the real reason statins work is because they reduce inflammation not because they reduce cholesterol. This is not studied. Statin drug companies have a lot of data they refuse to release. The main creator of the CAC score, Dr Agatston, has said low carb diet is the best way to address calcium build up and has recently updated his south beach diet to be closer to a real LCHF diet. Dr Dave Diamond has an excellent study to show people on a low carb diet with high LDL live longer. Not conclusive but evidence points in that direction. We need more studies!
I was expecting he will at least mention few numbers from 1 to 6 and discuss on it
Correct. I have Calcium score 4.1
What advancements have been made in finding cures to diseases since 1985?
They can't make money off you if you're cured.
Okay my score is 305 and I'm 76 years old.
What should I do going forward?
Same age, same numbers. I already exercise but will reluctantly start statins, have dropped from 161 lbs. to 145 lbs. in 2 months (easily) and will be dropping sugar drinks and ice cream (NOT so easily) and just hope for the best. You can only do what you can do and live your life.
I had a CAC with a dye. I guess that would be a wet CAC. He discussed what he called a dry CAC. Anyone know the difference,?
Hi
Mine around 220 my ldl 154 cholesterol 230 hdl 50. 73. Cant take statins.
I’m more confused than ever.
How does one rid one’s self of atheroma and/or CAC? Mine is 118 {0,4,114,0}. I damn near cried and hyperventilated when I saw it, especially when my PA friend told me the LAD artery (114) is known as the WIDOWMAKER😳😳🤯😭😭😭😭😭😭😭😭😭😭😭😭😭😭
Take 4 triple strength fish oil supplements daily. 2 morning before breakfast, 2before dinner. Your hdl and trigs will improve and can reverse Plaque. Stay away from bad carbs. Eat whole unprocessed food. Fish oil should be 3600 total omega 3’s. About 900 epa,dha combined per one pill. So 4 daily is your 3600. Get your LPa measured. If high may need upwards of 6000 daily omega 3’s.
I do a ketovore diet. I also take an unfortified cod liver oil and magnesium, nattokinase and K2 derived from natto (not synthetic). I also avoid high oxalate foods as calcium oxalate has been implicated in causing atherosclerosis.
I'm 76. My score is 305.
I'm determined to start exercising more.
@@njsongwriterprogress update?
will vitamin k2 remove plaque ?
K2 may remove the calcium (if it's natural K2 from natto) but nattokinase would be needed to remove the soft plaque. I take both.
Been on ppi for 25 yrs , recently found numerous studies that related the use of ppi to high cac score. Was diagnosed with atrial fib 25 yrs ago , the relationship was acid reflux caused my atrial fib , after taking prilosec for 5 days my atrial fib disappeared. Have to watch my diet closely, no oranges , coffee or high acidic foods. The catch 22 is I need the ppi 's to stop the development of Barrett's while at the same time the ppi ' s are causing causing calcified plaque. My cac score was 2049 july of 2022. Never have smoked , follow a strict diet and have been competing in powerlifting for 45 yrs. I was shocked at my score, the research showed me the reason, ppi are the culprit.
You should start watching all Dr Ken Berry’s videos.
Also watch Patrick Theut’s videos and read the book k2 and the calcium paradox.
Have you been on a statin during this time period? I heard also PPI increased heart disease if taken long term. I was on a PPI for 4 years and also a statin at the same time. My CAC Score doubled from a 25% annual increase to a 45% annual increase while on the PPI and a statin.
What is ppi?
@@tgchris2222 proton pump inhibitor--- reduces acid in stomach.
I really don’t understand why increasing calcium scores when you are on a statin are good but increasing calcium scores when not on a statin is bad. This sounds like a convenient situation for drug companies. But maybe I’m wrong. So what is the evidence?
Most admit that there is a correlation but do not say that one causes the other. Correlation is not causation.
Since the calcified plaque is thought to represent only 30% of the total plaque, it is the soft plaque that causes heart attacks by rupturing, it could be that the soft plaque not seen on a CAC scan calcifies thus becoming relative safe while increasing the CAC score.
You’re going to order a CT Angiogram for someone with a 0 calcium score 🤦🏻♀️
Folks check Dr. William Davis and Patrick Theut point of view. Be carefull with your ApoE gene type, inflamation and insulin resistence. Use koncentrated vitamin K. Good luck.
I disregarded my cardio’s advice across the board except to lose weight and refused statins. I was following Ivor Cummins and lost 80 pounds keto IF and prolong fasting… very successfully driving down all my negative metabolic markers. I saw Patrick theut on his show and added k2 and vitamin c …. CAC score was zero across the board and I was discharged by cardiologist who claimed he never had discharged a patient previously.
@@slay2525 How much k2 and Vit c did you take for this?
I would consult with Dr. Ovadia.
@@slay2525
What are you doing for soft plaque?
Interviewer needs to be able to efficiently and concise. The Doc is so articulate in explaining complex subjects and the host interviewer stumble around in putting his questions and comments together.
But then again who can follow the Doc in these type scenarios. Hard act to follow.
.
CAC score of 0, and my doctor wants me on statins, so i found a new doctor.
Whaaat? My dr told me mine was 0 and he said I was doing great
@@Viz210 that’s why I found a new doc. Zero reason to use statins ever. But even more so for a cac of 0
Who does these scans ? What do I google ? CAC scan ?
Any imaging center
We went to UPMC in Pennsylvania. Cost = $99
I googled CAC near me and found one an hour from my home and it was $50
@@michelleweaver3279 thank you 😀
I have been lifting weights and doing cardio since my teens. I am 39 now. Just got My calcium score of 67. I have no family history of heart disease. Always have eaten healthy. I have no idea how I got a score of 67.
Do you know what you will do about it? I recently discovered I have a non-zero calcium score at age 41 after learning my lp(a) is off the charts high.
@wrongworld I have started statins for now to calcify any soft plaque. Add more cardio (V2 and V02max) eat healthier.
Try my best to manage stress.
Hopefully things get better.
@@learnmore6120 what prompted you to get the score? It’s scary that the data on cac doesn’t start until age 45. Like you I’ve lifted weights all my life and have done a lot of cardio. My vo2 max is in the excellent category. Life can change in an instant, can’t it? Best of luck to you.
@wrongworld ask ur doctor to write u a CAC even if he says no just tell him to do it.
@@learnmore6120 I took the test last week. Just wondering why you took it. Have you had your lp(a) tested?
At first glance I thought you guys were smoking shishas.
Is the CAC score reversible?
Following
Read about k2 and calcium
Watch this...
czcams.com/video/ysifMKWKZLY/video.html
According to allopathic medicine, no because there is no pharmaceutical drug to reduce plaque. Look up the root cause protocol from Morley Robbins.
My calcium score at 63 was Zero
Explain please?
My cardiologist has never mentioned or suggested the calcium test.
I'm a thin 5' 7" 135 lbs fit 76 year old with no symptoms of any health problems and have been on Keto for almost 4 years. Just got a requested by me CAC scan with a result of 1114.5. My most recent blood test results were a trigyceride/HDL of 1, CRP
Are you Apo E3/4? And have you checked Lp(a)? Looked at LDL-P? Small dense LDL? These can be check with NMR Lipoprofile. And Lp(a) and blood labs.
If you do your genetics through 23 and me, and then run your raw data file through Found my fitness genetics (Dr Rhonda Patrick), you can see if you are Apo e 3/4, which can be more sensitive to saturated fat. Look at Apo E 3/4, lots of websites and articles online.
And there are other genes that can make you poor at metabolizing saturated fat you may find in your full genetic report. For some people with these genes, high saturated fat diets (like Keto), may make LDL-P and cv disease worse. I have seen this with some clients doing Keto, despite good HDL/Trig ratio, good glucose/insulin, good weight, and other seemingly healthy metabolic makers.
I think the best next step is to go study Dr Brewer’s (PrevMed) videos! He has LOTS of information about CAC along with heart attack and stroke prevention! He talks about controlling inflammation and insulin as a key ways to prevent cardio events and stroke.
Probably taking the Kraft Insulin Survey or OGTT WITH insulin markers to find out if you have insulin resistance is your key next step. Plus get a good CIMT done at a technically reliable place. (Call Cardio Risk to find out where you can get the scan in your city)
A possible best case scenario for you could be that the high calcium score reflects that your have already done some damage control to the plaque that you have accumulated in your arteries before your current healthier lifestyle and Keto diet? But whether your body is still making soft plaque is the key question.
@@pollyptwan Thanks for your input. My last blood test showed total insulin of 5 with a range of 3 - 25 uIU/mL and my CRP < 1 which indicates low inflamation. I had a high carb/low fat very little sugar vegetarian diet for most of my adult life prior to switching to Keto. It will probably take years for my body to heal from the vegetable oils, gmo foods and all those carbs.
@@roncav8 Yes, I think we have all done damages to our health when we followed all the wrong suggestions on what was healthy for us in the last decades!
As for an insulin of 5, according to Dr Brewer, a fasting "snapshot" still doesn't mean you don't have insulin resistance at all. The best test to find out for sure is the Kraft Insulin Survey. We need to be put under a "challenge" and actually do a tolerance test and watch our insulin response to the glucose challenge for three plus hours.
Good luck!
PS: I have been researching all this because I recently got a 1300 on my CAC as a 60 yr old female!! Otherwise, I am healthy and symptom free. I also have normal BMI, pretty good blood work numbers, and eat a low carb high fat diet! But of course my case is much worse than yours since I am only 60. I have been learning so much on Dr Brewer's channel. :)
Wear a CGM for a couple weeks to check your glucose levels.
So if calcium is present in the cardiac arteries, does that mean that someone has had a Cardiac event (a minor heart attack)?
No, but they may have had a heart attack. What it really means the higher the number the more likely an event in the next years. It’s not a perfected science yet, because a heart attack could start in a non-calcified area.
You can think of it as a scare. There's been some damage there, and is was repaired. He says "generally" those areas are now stable, and there's nothing you can do about it, nor should worry about the areas already scared. What you need to have assessed is what are your risk factor(s) moving forward, and what to do about it. This is where an experienced cardiologist takes his time and does an analysis of your cardio health based on multiple factors, and CAC is just one.
BTW, I was able to find several MESA risk calculators online, but I won't share them because they are best rough estimates. Also, I found one that as HDL went up, risk went down, and according to current studies, I don't know that a higher HDL is still being considered protective.
@@Joseph1NJ Keep in mind: a cardiologist may tell you to take a statin and eat bad oils. You need to see a cardiologist who is up-to-date on valid research.
My score was .8 and I was put on 5mg statin.
My score is 2800...
Dr Rogge says it's not in the arteries and he wasn't overly concerned 🙄.....he did perscibe a statin.
Now I'm as concerned as I was before when the score was 1200.
any thoughts..
Time for a 2nd opinion?
Please research the keto/carnivore way of eating. Here is a video by Dr Ken Berry. czcams.com/video/ZqtXTP2BDgc/video.html
What do you mean, "It's not in the arteries"? Is it a CAC score or not?
How can it not be in the arteries? Wtf are statins going to do? Calcium is from inflammation not from high cholesterol.
Get together with some dental hygienists. We can tell you about mineral build up and how the dental Association has gotten it all wrong since the beginning. Dental Calculus forms fast and furious for some and MUCH less quickly/heavily for others. It does NOT mean they are bad tooth brushers. It’s because there are more minerals floating around in some peoples systems. I would bet a million dollars that there is a correlation between the calcified artistries you just discovered and their dental calculus. It would be MUCH cheaper for you to look at their dental history to find out how much minerals they have floating around in their system than to give them an angiogram or whatever invasive thing you’re doing to check what I can see for free in their mouths.
Calcium is normal in most people do to the bodies ability to regular it. You never hear of a person with high blood calcium as related to high calcium score. You are miss reading this issue.
@@PianoUniverse oooh.. right, I should listen to you. I’m sure it’s “do” to the ability to “regular” it.