Could you possibly have enough plaque in your arteries to put you at high risk of deadly heart disease and yet have normal cholesterol, blood pressure, and weight? New research says absolutely yes, but it also reveals that a calcium score test can accurately measure your true risk.
How do you know if you have heart disease, the number one killer in America? While some people have symptoms like chest pain and shortness of breath, most people have no symptoms at all. In fact, for many, the first symptom is death. But it doesn’t have to be that way: The calcium score test is a quick, easy, non-invasive, $99 test that finds heart disease before it turns deadly.
Most imaging tests that visualize the arteries that supply the heart are expensive, time-consuming, invasive, and/or risky, and some of them just don’t do a very good job of confirming the presence of calcified plaques clogging the heart’s arteries. Doctors and researchers have been debating for years whether it’s worth it to look for heart disease in patients with no symptoms, given the expense and invasiveness of most of these tests. In the last few years, however, more studies support and more doctors are recommending the coronary artery calcium score test as an easy, quick, inexpensive, and relatively safe way to visualize coronary artery disease.
The coronary artery calcium score test is a painless test done by a CT scanner. It supplies less radiation than a chest CT and does not require any IV or contrast dyes, as do many of the other imaging tests. This test measures calcium deposits in the coronary arteries. The calcium is part of the calcified (hardened) plaques, which are gradually formed due to inflammation and oxidized cholesterol and fats in the walls of arteries. The amount of calcium seen on CT is related to the amount of underlying coronary atherosclerosis (hardening of the arteries of the heart), the hallmark of coronary heart disease.
New studies, just presented at the American College of Cardiology’s 2014 Scientific Sessions, show calcium score tests to be better at predicting long-term heart problems than other available tests, particularly when evaluating low-risk patients. A Houston Methodist Hospital study, for instance, found that coronary calcium testing in people with no heart disease symptoms is definitely worthwhile. Nearly 1,000 patients, most of whom were considered low risk for heart disease, were given a calcium score test and a plain exercise treadmill stress test and then tracked for seven years. The coronary calcium score test proved a far better predictor of risk. Lead study author Su Min Chang, M.D., said the results show that calcium scoring can help catch patients who are on the way to developing heart disease earlier than other available tests.
A low calcium score suggests a very low risk for blocked coronary arteries and coronary events. The optimal calcium score is zero (no calcium detected). Scores of 1 to 99 are generally considered low; 100 to 399, moderate; and above 400, high. People with low scores (less than 100) have less risk of cardiac events like heart attacks, and the risk increases as the score increases. A high coronary artery calcium score can help to predict heart attacks or the need for coronary bypass surgery or coronary (balloon) angioplasty.
Even patients with low calcium scores (1–99) are 50% more likely to die than patients with a score of zero, according to another recent, 20-year study presented at the American College of Cardiology’s yearly conference. Nearly 5,600 subjects from UCLA Medical Center were followed for an average of 10 years. All subjects were considered to be at low risk for heart disease, and those with calcium scores of zero were compared with those with low, moderate, and high calcium scores.
Moderate scores (100–399) were associated with an 80% greater likelihood of dying, and high scores (above 400) were associated with a three-times-greater risk of dying as compared with patients with zero calcium. Clearly, it’s possible to have a deadly amount of plaque even if you’re traditionally considered low-risk based on your cholesterol, blood pressure, weight, smoking status, etc.
Don’t hesitate to discuss the benefits of coronary artery calcium scoring with your doctor. In some states, you can decide to get the test yourself without a doctor’s request just by calling and scheduling with diagnostic imaging departments directly. The average cost is only $99.
If you do have a higher-than-optimal calcium score, there is a lot you can do to decrease your risk of having a heart attack. Rather than focusing on any one therapy, maintaining an overall healthy lifestyle has been found to be the best predictor of keeping calcium scores low, the heart healthy, and living a long life, another study found. A low-sodium diet filled with fruits, vegetables, whole grains, healthy sources of fats, and lean protein is a key, as is moderate exercise, stress reduction, and good control of blood pressure and blood sugar. You’ll find information on all these therapies here, in our comprehensive guide to lowering cholesterol.
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