r/YouShouldKnow • u/maintain_improvement • 1d ago
Other YSK: You can have clogged arteries without high cholesterol
Why YSK: I get bloodwork done at least once a year. My LDL was never high until this past year, and even then it was barely into the high range (111 mg/dL). I am male and just turned 46.
My job offers free CAC chest scans as an insurance perk. I got one done. Turns out that my LAD artery is fairly clogged. I am more clogged than 90% of my peers. I can control this by taking a statin and 81 mg aspirin, as well as diet, but if I hadn’t gotten checked, I would have been looking at a heart attack in 3-5 years.
I had no symptoms.
If you have the means, please get a scan.
267
u/xavier10101 1d ago
The reverse is also true! I have terribly high cholesterol but I got a CAC scan and I'm completely clear! Plan to get one every 3 years or so just to confirm.
175
u/MiloEth 1d ago
Reminder that younger patients can have a low or zero coronary artery calcium score and still have soft plaque that a non-contrast CT (the modality used for calcium score) would not pick up. Plaque takes time to calcify.
If your LDL or LPa are elevated, I would strongly still consider at least a low-dose statin.
(I am a cardiologist)40
u/xavier10101 1d ago
That's what my doctor says as well. I do plan on taking her advice, and I appreciate you taking the time to write this out!
3
u/thnlsn 17h ago
I started with a new doctor 5 years ago at age 24 and it was the first time I’d had my lipids checked and I had 190 LDL at the time. I had also told him about how I had an uncle who died at 30 to a heart attack, though all of my direct family have great LDL results. Regardless, to me it still seemed like I should start on statins anyways.
Instead, he just told me to just cut out red meat and try to keep saturated fat intake to <10g per day. I did this pretty well (as well as lost ~20lbs) and got it down to 130 LDL the following year. At this point since it was still elevated I asked about statins again and he said to consider it strongly if it doesn’t get under control with diet and lifestyle by age 30.
In the next few years until now (age 29) it stayed in the 130-160 range, and I’ve done more research and I really wish I had just started with the statins right at the start. I’ve probably had terrible cholesterol my whole life (but couldn’t find records from childhood) so I worry about the cumulative build up I’ve had all this time. The one good result I had was Lp(a) which has been <10 nmol/L ever since I started tracking that a couple years ago.
My last appointment I basically insisted to start a statin and so I am finally starting. Wish it had been much earlier but hopefully since I’m still relatively young (29) it’ll be good preventative care. I also asked to do a CAC scan so I can see what kind of cumulative damage I’ve accumulated thus far, and so I’ll be scheduling that soon.
Maybe I am being more worried than I should be, because my doctor has been so seemingly relaxed about it all this time, it really doesn’t seem like an big concern to him (maybe because of my age? I’ve read about the 10-year risk that doctors supposedly operate on, so maybe by that measure I don’t flag any markers), but my research tells me it is a legitimate concern, especially if I’m concerned with preventative care and longevity. I’m actually a bit bothered that he didn’t just recommend the statin much earlier.
I’m considering booking an appointment with an actual cardiologist as well just to get a baseline assessment of some kind.
1
u/HipOut 16h ago
From my understanding theres’s no real negatives to statin except maybe some joint pain side effects and yeah you wont want to drink alchohol maybe cant take certain meds.
I had high LDL lost year and was resistant to taking statins it just felt scary to be on meds forever. Once I started learning about that I’m like holy shit maybe I wanna get on these sooner than later to prevent any cumulative damage.
Anyways I lost 25 pounds and my LDL is borderline healthy levels now so I’m not on statins. I’m eating a lot of fiber and very aware of my saturated fat intake. I eat oatmeal every day lol. Fiber and weight loss will surely help a lot but yeah, why not go on a statin
1
u/MiloEth 15h ago
Yes, very minimal side effects for statins especially low dose such as Crestor 5 or Lipitor 10. The myalgia risk with these doses is almost negligible. Also no issue with drinking alcohol while on statins unless your liver enzymes are elevated for some reason. Obviously for a variety of reasons, keeping alcohol to a minimum is ideal.
1
u/MiloEth 15h ago
It is definitely a legitimate concern and good on you for insisting on a statin. Ultimately we can’t say no damage was done, but you’re young and you’re starting relatively early so you’re ahead of the curve. The statin you’re taking won’t only reduce your LDL and decrease further plaque build up, it will also stabilize any current plaque and decrease the chance of plaque rupture (AKA heart attack AKA MI). I would definitely recommend seeing a cardiologist.
1
u/RuinYouWithNoRegrets 1d ago
What’s your opinion on a coronary artery vessel wall mri in place of CTa for thkse who don’t want radiation
8
u/MiloEth 23h ago
We don’t routinely use MRI to evaluate coronary plaque. For one, slice thickness is smaller and therefore more defined/sensitive on CT. A CT calcium score uses an incredibly low dose of radiation, and a coronary CT angiogram (with iodine contrast) still does not use a significant amount of radiation, and is now becoming often preferred over other modalities for ischemia (such as nuclear stress test or stress echocardiogram) because of a relatively new technology called CT FFR which I won’t get into the details of but basically lets you know if the blockage you’re seeing is hemodynamically significant enough to cause ischemia (lack of blood supply which leads to angina). So these days coronary CT angiogram gives us both an anatomical evaluation (what the vessels look like) and ischemic evaluation (do the blockages pose hemodynamic significance requiring intervention). MRI to my knowledge does not have anywhere near similar capabilities.
1
u/RuinYouWithNoRegrets 23h ago
I guess for someone young (under 30) who doesn’t want the big dose of radiation from cta or a possible contrast reaction like thyroid or kidney injury I was wondering if a mra of coronary arteries or the mri of the coronary vessel walls to show soft plaque or inflammation /wall changes would suffice
1
u/MiloEth 23h ago
MRA that you’re referring to has its own gadolinium contrast with its own complications and no, it wouldn’t suffice for the purpose of ruling out calcified or soft plaque. The radiation quantity of a CAC is negligible, and the radiation quantity of CCTA is only slightly over negligible.
1
u/RuinYouWithNoRegrets 23h ago
I got a cac scan of 0 but chest symptoms persist but I just don’t want a bad reaction to the contrast .
3
u/MiloEth 23h ago
If you have symptoms a CAC is never a correct choice of test, as it is not an ischemic evaluation. Your options of ischemic evaluation are 1. CCTA (but you don’t want the radiation or dye), 2. Nuclear stress test (but you don’t want the radiation) or 3. Stress echocardiogram which sounds like the best choice for you, but please discuss this with your cardiologist as I don’t know your specific story well enough. Good luck.
1
u/RuinYouWithNoRegrets 23h ago
Thank you. I’m only 25F so they don’t wanna expose me to more radiation. My stress echo and carotid ultrasound was normal tbh. I’m weighing whether a CTA would be worth it
1
u/MiloEth 23h ago
At 25 with a normal stress echo the odds of you having coronary ischemia are incredibly low and I would look to other potential causes of pain, but again I would talk more with someone who’s actually your doctor.
→ More replies (0)1
1
u/TwinMugsy 16h ago
Before the plaque has calcified, is there anything extra that can be done that can't be done to fully calcified plaque?
3
u/MiloEth 15h ago
Ultimately it’s just starting cholesterol control early. The guidelines are actively changing, the old LDL target above which we’d start a statin in a young healthy person was 190 but we’re realizing that’s way too high. These days the target is really under 100 for everyone and even as low as under 55 for people with coronary artery disease and risk factors. We try a lot of diet and weight loss which are very good don’t get me wrong, but it’s hard to diet away genetics sometimes. I’m personally of the mindset that Crestor should be in the water. Statins not only reduce bad cholesterol and therefore reduce plaque build up, they also stabilize existing plaque and reduce the risk of plaque rupture (which is the cause of a heart attack AKA myocardial infarction).
1
u/drhappycat 15h ago
(I am a cardiologist)
How far away from a total cure for this are we? Or even an easily swappable artificial heart. Because even though everyone currently doing it will INSIST it's not true, longevity achieved through the misery of eating cardboard and denying yourself is shit quality longevity worth far less than dying young but with a smile on your face.
1
u/MiloEth 14h ago
Couldn’t really tell you. Total artificial heart is something very select centers use temporarily in an ICU stay as a bridge to actual heart transplant. Heart transplant in itself is a morbid surgery with difficult recovery and very high amounts of immunosupression (higher than for example a kidney transplant), and current average lifespan of about 10ish years, obviously depending on a variety of factors. These are clearly not things you want to rely on when your current issue is high cholesterol and a “simple” solution is eat better, lose some weight, and take a statin. We are nowhere near close to a simple artificial heart that can just wipe away all our problems.
1
u/Amlethus 6h ago
What are your thoughts on PCSK9 inhibitors vs statins? Statins have caused me muscle pains and PCSK9 meds sound very effective but I'm not sure if there are hidden downsides besides the injections (nbd tbh).
1
u/MiloEth 6h ago
PCSK9 inhibitors are one of the best medication class to ever come out I think. They do exactly what they’re intended to do, incredibly effectively, with minimal side effects. The only issue is cost/insurance coverage and people willing to inject themselves until the oral one becomes more popular.
17
u/Tetsubin 1d ago
Same here. My whole family, including me, has very high cholesterol, but my calcium score on a recent scan was zero.
→ More replies (1)→ More replies (5)2
u/grumpypeasant 1d ago
CAC is a terminal late stage finding. In anyone under 50 the expectation is a score of 0. It says absolutely nothing about how much soft plaque (the kind that bursts and causes heart attacks ) you have. Plaque needs to be there for 20 years to calcify
171
u/GrantMeThePower 1d ago
Same thing happened to me. Young, active, healthy, good diet, athlete…CAC of 520. 99th percentile. Suddenly have a cardiologist, angiogram, and medication and never had a cholesterol problem or any symptoms of any issues.
39
u/Fringelunaticman 1d ago
My CAC was 303 and it scared my doctor. So I was asked to do a nuclear stress test. Didn't have insurance so did a nuclear coronary CT which came back mild atherosclerosis. Doctor still wanted to do a stress test so I ended up with insurance and had one. My METS was 19.2 and everything my doctor was worried about disappeared.
Doc thought my high CAC score was a result of poor lifestyle choices in the past and the calcium scars were just remnants from that past.
Btw, I had to take the CAC because my LDL was 110 for 3 straight years.
0
u/zubeye 1d ago
the damage is cumulative, so the fact the scars happenedin the past and your excercise is good, doesn't reverser the damage .
5
u/Fringelunaticman 1d ago
Depends on what you mean. The calcium will always be on my arteries. And that damage is irreversible. However, the plaque that causes that calcium may still be there or it may not be. And the more plaque, the more narrowing of the arteries. The CAC shows significant calcium build up but the CT shows less plaque than the CAC suggests. And the stress test shows no plaque or narrowing.
So what is the reason I have calcium on my arteries but no plaque?
1
u/zubeye 1d ago
The plaque may solidify but I don’t think it leaves
2
u/Fringelunaticman 23h ago
According to my cardio, plaque can leave. And, depending on how much leaves is what gives you with a stroke or heart attack. A big amount can kill you, small amounts get absorbed back into the body.
I am just repeating what the cardio guys ive seen said.
3
u/Tao-of-Mars 1d ago
Do you mind if I ask what your diet is like? For real, my dad passed from congestive heart failure and I had not had issues with cholesterol til I stopped being fat-phobic. BUT I had also transitioned to pescatarian diet. I had never been much of a red meat or pork eater. It boggles my brain. I reduced my intake of coconut oil, since I used that as a replacement for butter for a while. Didn’t help a lot. I also started taking a supplement called inositol and it doesn’t make much of a dent either. Is heredity that much of an issue with cholesterol?
4
u/matthew7s26 22h ago
Is heredity that much of an issue with cholesterol?
It can be a MASSIVE reason for high LDLs. I ate clean while attempting to lower mine, and it hardly made a dent. Time to start statins in my 30s...
1
u/Tao-of-Mars 17h ago
I guess me too. Especially being that I’ve eaten had a plant focused diet my entire life. Wild.
66
u/random_reddit_user31 1d ago
I need to have this done. My dad has congestive heart failure at 54 and he had his first heart attack at 39. I'm 35 so I'm getting close to that age. It honestly scares the shit out of me.
27
u/maintain_improvement 1d ago
Get it done. It is my understanding thatt without insurance it is $75.
9
u/boring_name_here 1d ago
My insurance doesn't cover it for some reason, and it's going to cost me $100. I need to know it anyways, so yay.
5
43
u/parttime_use 1d ago
What is a CAC chest scan?
47
17
u/Orion14159 1d ago edited 1d ago
Coronary artery calcium scan - if your arteries are calcium scaled it might not show up on a standard lipid panel but might show you being clogged up or not
24
u/FaithfulNihilist 1d ago
A coronary calcium scan is a special computerized tomography (CT) scan of the heart. It looks for calcium deposits in the heart arteries. A buildup of calcium can narrow the arteries and reduce blood flow to the heart. A coronary calcium scan may show coronary artery disease before you have symptoms.
Coronary calcium scan results can help determine the risk of heart attacks or strokes. Results from the scan may be used to plan or change treatment for coronary artery disease.
https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686
6
1
u/Dramatic_Respond7323 17h ago
From India I was surprised CAC isnt popular here. I went to one if the most famous hospitals in South India, Manipal KMC. I asked for CAC and doctor said we dont have. Instead they offered echo and TMT. He said angiogram is available but wont suggest for me.
36
u/DawnCB20 1d ago
Great info! At my place it’s $95 cash, no insurance accepted. It’s a 10 min Cat Scan. We place ekg style stickers on your chest, have you elevate your arms over your head, and before you know it, you’re done. Super easy! And informative
6
1
18
u/Bar98704 1d ago
Would this have affected your blood pressure? Is the scan the only way of knowing it’s clogged?
16
9
u/ianawood 1d ago
Get your Lipoprotein A level tested. It's a big indicator that will change how your doc determines what cholesterol levels are good for you. It's a one time test (levels don't usually change) and not usually influenced by lifestyle.
4
8
u/Catladyweirdo 1d ago
What was your diet like before?
4
u/maintain_improvement 1d ago
Good to Very good for most of my life. Not so great from ages 41-44
22
u/HexicDragon 1d ago
What does a good diet look like to you? There's people walking among us who think Carnivore diets are what a perfect diet looks like so we can't take anything for granted lol.
9
u/fasterthanfood 1d ago edited 1d ago
Not OP but this was roughly me. I didn’t eat a carnivore diet, but I did focus on high protein and low sugar. Lots of vegetables compared to the average American, but not quite at the recommended levels. I felt good and thought my diet was on point. My LDL was over 150. (Cardiologists recommend under 100 for most people, lower for some higher risk groups).
I assessed my diet and saw I was having way too much saturated fat and too little fiber. I changed those two things and a few other small things like filtering my coffee (nothing too hard from a lifestyle perspective and no drugs), and 4 months later my LDL was in the 80s.
It’s not so easy for everyone, and if you need a statin you should get on one ASAP, but in some cases the needed change is fairly small but very significant.
5
u/HexicDragon 1d ago
Awesome, good job lowering your LDL! Yeah, those healthy habits can't be taken for granted and what's harming your health isn't always intuitive. Protein is treated as the most important nutrient by many people, but far more Americans (over 90%) don't eat the minimum amount of fiber and one cheese pizza can have more saturated fat than you should ideally eat in several days
-5
u/maintain_improvement 1d ago
27 bratwurst for breakfast and a strict Sour Patch Kids only diet the rest of the day.
6
u/CrimsonSuede 1d ago
Thank you for this YSK. This happened to my stepdad.
He didn’t do the last test. Half a year later, went into cardiac arrest.
Thankfully it was at home and I could do CPR. He’s fine—no heart or brain damage—and while he goes to his appointments and tests, he hasn’t been sticking to the dietary changes well /:
But yeah, we were all taken aback given his apparently totally fine cholesterol blood test values.
6
u/cwsjr2323 21h ago
Agreed! After a surprise finding I now get an annual full physical with blood work through the Vetersns Administration and an annual wellness physical through Medicare. They are separated by six months so I get checked teice a year.
My turning sixty physical was my surprise. The nurse said she thought my pulse "felt funny", so the doctor ordered me a chest X-ray and heart stress test type EKG. I got referred to a cardiologist who read the tests and he said I had blockages. He did a heart shunt and and did surgery to unblock a carotid artery. While he had my neck open, he said I was close to having a stroke as the artery was in bad condition, had a bubble that could burst so he replaced the artery. I had felt just fine before the physical.
My daily medications for gout, cholesterol, high blood pressure, and aspirin for for my heart are the first course of my lunch now. At 74, I have no fear of death but am NOT in any hurry.
11
u/zubeye 1d ago edited 1d ago
your heart attack risk (to take a wild guess) within 3 years would have been probably something like 3%
to compare, the base line risk is about 1% in the general population.
With lifestyle and meds meds you split the difference, very crudely speaking, so you are now about 2%. a big relative improvement sure
we are all at risk
5
u/fasterthanfood 1d ago
Most people are concerned about their risk over a lifetime (hopefully another 50 years for OP), not just their risk over the next 3 years, though.
4
u/Hot-Philosophy-7671 1d ago
I have this, and the only reason I found out was I got a GP who regularly tests for it because they have it.
Lp(a) is genetic and is mostly unaffected by diet. The only things that help are statins and Niacin therapy. Doctors usually don't test for Lp(a), so you have to ask, and some doctors I've had refused to listen.
Get tested. If you have it, tell your blood relatives.
8
3
u/jacktooth 1d ago
I’m awaiting results from mine, as I did a treadmill test and blood pressure peaked at 230/43, they had to stop it early before I collapsed. I’m on statins and blood pressure meds but doesn’t seem to be coming much lower than 130/70 day to day. I’m hoping something is blocked and not end up on blood pressure meds for life
5
u/Glittering-Cat1146 1d ago
Whoa, wild timing. I also recently learned that my LAD artery is also fairly clogged with calcification incidentally through a cancer screening CT scan. I have never had high cholesterol, blood pressure, or anything like that, ate well, worked out.
I have a CAC scheduled for Friday this week.
4
4
u/Walkera43 1d ago
People think you only get high cholesterol if you eat a lot of fatty food, but diet only gives control over 20% of your cholesterol and your liver controls 80%. I had a healthy diet and two semi blocked arteries.
5
u/villanelle21 16h ago
Hey OP, please look into the risks associated with long-term statin use. Statins triggered necrotizing myositis in my dad and nearly killed him. He deteriorated very quickly, and it took several doctors scratching their heads while he was wasting away before a rheumatologist finally figured out what was happening. Thankfully, he is now safely off statins and in physical therapy.
4
u/Vwelyn 15h ago
This happened to my husband. LDL was borderline, calcium score was zero. One day he went out for a jog (he is very athletic), felt an incredible sense of impending doom, and came home. He went to the doctor, doctor thought maybe anxiety but sent him for an angiogram just to be safe…. His LAD was 90% clogged, his circumflex was 100%. He was admitted immediately and had a triple bypass at 46. Now his goal cholesterol is stupidly low, but he’s still here, and that’s all that’s important. He got very, very lucky.
1
3
u/pickandpray 1d ago
I got the cac scan because it's like $75. It's cheap because it serves as a lead generator for the cardiologists.
In my case the high score over 800 generated demand for a handful of tests and scans which ultimately led to a $45k stent placement through my wrist that maxed out my out of pocket costs for the year ($9k).
Get the cac at the end of the year because you'll need a few months of tests that can start at the beginning of the year, unless you already have medical expenses booked for the year.
My cardiologist visit was in January and my stent was placed in May.
3
3
3
u/Wenckebach2theFuture 1d ago
Plz know, CAC does not mean clogged. It means there is calcium deposited around or in the artery. Using contrast will determine if the inside of the arteries actually has clog or not. It is very possible to have high CAC, but still have good blood flow inside the vessel and no clogs.
3
u/nathanbforrest 21h ago
I had normal cholesterol and had a heart attack at 38. 100% blockage of my left anterior descending artery. My lp(a) was over 200. Zero prior warning signs.
1
u/ndg5800 17h ago
How are you doing now ? What follow up and other intervention are you doing ?
1
u/nathanbforrest 16h ago
Pretty shit. I thought it was heartburn or an ulcer so I waited overnight to go to the hospital. I had a stent placed in my LAD and the other one was ballooned open. The wait caused some damage to my ventricle wall, which has recovered some, but not 100%. I'm on a bunch of meds to keep my heart rate and BP low, so that makes me feel like shit all the time. I started repatha in February and haven't had my lp(a) checked to see if it's gone down yet.
3
u/teatrouble 20h ago
My late husband passed from this. He was 29. Healthy, slightly high ldl, suddenly and overnight
4
3
u/kitkatkorgi 19h ago
Gotta have a calcification and soft score and your APO b checked to see what size of cholesterol is coursing through your blood.
3
u/FWYDU 18h ago
Also, the AHA/ACC just updated their cholesterol guidelines (2026) and are now recommending a couple of tests beyond the standard lipid panel: a one-time Lp(a) check for everyone, and ApoB testing to get a direct count of artery-clogging particles (rather than just estimating from cholesterol content, like standard LDL-C does). ApoB is considered a better predictor of heart disease risk, especially when it disagrees with your LDL-C number. At Quest, this kind of expanded panel is sold under the CardioIQ brand. It cost me about $130 with my insurance vs the $40 the standard lipid panel. Worth asking your doctor to order ApoB and Lp(a) specifically if you want to see where you stand. For me, this prompted a Cardiologist referral to get an Angio CT (with contrast) done to see how my arteries look (any atherosclerosis). I'm doing that next week. Costs about $1300 with my insurance, but worth it to me. (I have Pattern B type and high LDL count. Pattern B is dense LDL particles that like to stick and cause plaque. The big fluffy particles (Pattern A) are better)
Edited to add more context
4
u/JazzFan1998 1d ago
What diet changes help? Please be specific. No meat? Dairy, etc?!
4
u/maintain_improvement 1d ago
I went heavy on the Mediterranean diet, and my cardiologist agreed, but I want to make it clear that I am not giving specific medical advice
1
u/Glass-Helicopter-126 16h ago
Lower saturated fat (reduce red meat, skin-on or dark meat chicken, full fat dairy, butter, coconut, palm), increase fiber (beans, lentils, oats, psyllium husk (e.g., Metamucil))
2
2
2
u/willingzenith 1d ago
Same! I’m slight older and very similar LDL numbers to yours. Had a CAC this year and was surprised to score over 100.
2
u/IceKingWizard 1d ago
Some studies show we begin developing plaques way earlier than expected. As in some newborns are shown to already have coronary plaque build up or the precursors to atherosclerosis present in the coronary arteries.
2
2
u/martphon 23h ago
My cholesterol is not high but an x-ray for a serious cough turned up a calcified aorta. I thought my insurance was pretty good, but I had to pay for my own CT scan to see how serious it was. Doctor put me on statins
2
u/PenIsGodS 23h ago
If you have no insurance, look into $50 cardiac calcium score scans in your city. No insurance or dr referral needed. Not all cities have places that offer this obviously, but many do.
2
u/Legal-Swordfish-1893 22h ago
Went to the ER because of some back pain. Came out with atherosclerosis.
Fuck. I only just exited my 20s.
2
2
2
u/hdmiusbc 20h ago
I'm having one of these done in 2 days. It's only $150 without insurance in case anyone was concerned about the prive
2
u/RonaldWilsonReagen 19h ago
No one has addressed the only problem that actually exists and that is will insurance payers reimburse for the test and the answer is no the only thing that needs to be checked. Is your LDL cholesterol and if it is below 40, then you’re at goal and you can start to begin to get plaque regression anything above that and you get growth. people have to understand you don’t have to take a statin. There is this thing called Repatha but insurance companies don’t wanna pay for it and providers. Don’t want to do the work in order to get the prior authorization approved. It’s cheap. It’s effective. The overwhelming evidence is an LDL under 40 all the other stuff while interesting will not get any additional treatment.
All the other stuff ob triglycerides HDL none of it gets you anything better all it gets you is more knowledge. The only thing that will work is lowering the LDL now there’s leqvio, but it’s not as good. And there’s a whole lot of new stuff that’s coming out oral PSK nine inhibitors. I think Merck has one. I think Amgen‘s coming out with one. I think Lilly has one. But everything that has been discussed above or below as far as I can tell the calcium scores all that doesn’t really get you the Repath and that’s the thing that actually works.
2
u/star_tyger 16h ago
You can slso have high cholesterol without clogged arteties.
The correlation between high cholesterol and clogged arteries is not that high. Thevtest should be a standard part of a physical, but it isn't. If you can, get the test.
2
2
u/lycanter 1d ago
If you are literally more than 90% clogged you need a heart cath. They will stent arteries above 70%. I’m in my 40s too and I’d do it.
20
1
1
u/GreatWhiteHulk 1d ago
Look into Repatha instead of a statin. I take it every two weeks and it doesn't have the potential short term or long term side effects statins do.
1
u/rollingthestoned 1d ago
Yes you can. My PCP recommended this simple imaging test and it got me just ahead of the curve although I had a moderate CCI score.
1
u/Battle-Choice 1d ago
My cholesterol, blood pressure and weight had all dropped to healthy, normal levels over the last 6-8 months of working on myself. Then found out last week my CAC score is 432. I'd been overweight several decades ago but not for more than a few years, as well as not drinking or smoking for the last couple decades.
My 54-year-old brother passed last Feb from a "double widow maker" as the Dr called it. I love feeling better physically but it also sometimes feels like it won't matter for much longer. You can stabilize your number through all these efforts, but it will not drop.
1
u/BijouPyramidette 23h ago
Does anyone know if supplementing vitamin K2 can help here? It's supposed to encourage calcium to go into bones instead of arteries, and I take it together with vitamin D.
1
u/Battle-Choice 19h ago
I've started taking a K2/D3 supplements along with the repatha.
1
u/BijouPyramidette 19h ago
I started taking it when I broke my elbow and was taking calcium supplements to encourage the bone along. I don't take the calcium anymore but I'm still doing the vitamin D3/K2 combo because vitamin D deficiency is so common.
1
u/mikesfsu 22h ago
What was your CAC score? I was told by my cardiologist once I had calcification of any kind it was not reversible but statins could help to keep new plaque from
Forming.
1
1
u/nevertricked 20h ago
The statin and aspirin are not even bare minimum. If your LAD is 90% occluded, you need to be getting a stent.
1
1
u/hatboyslim 19h ago
Do you have a history of heart attacks or cardiovascular disease in your family? That is another risk factor.
1
1
1
u/Youwillgotosleep_ 14h ago
You can have a clean calcium scan ie 19%, less than 10% is low risk, and still have a heart attack less than 6 months later. I know this from personal experience. Calcium scan only identifies harden plaque not soft plaques which can still cause an obstruction of the vessel. I am in my very early 40s.
1
u/IamNotTheProclone 14h ago
My dad passed in may from a sudden massive heart attack at 58. We were dumbfounded because he never had high cholesterol or high blood pressure. His yearly physicals would always go well.
Guess who's seeing a cardiologist next month.
1
-1
u/VirtualMoneyLover 1d ago
YSK: Cholesterol is a complete bullshit predictor of CV health. Half of heart patients have normal cholesterol levels, thus a cholesterol measurement has the predictive value of a coinflip.
4
u/maintain_improvement 1d ago
Exactly why you should get a CAC scan
-1
u/VirtualMoneyLover 1d ago
Correct and forget about cholesterol. Also statins don't dissolve plaques.
2
0
u/grumpypeasant 1d ago
This is incorrect. LDL cholesterol or more specifically Apolipoprotein B containing particles (which include ldl, vldl, lp(a) and ldl) are causal in artherosclerotic plaque. This has been demonstrated beyond plausible doubt by hundreds of prospective and observational trials and Mendelian randomization studies.There can be quite a few explanations why you specifically are more susceptible at lower ldl levels:
1. Genetics
2. Other risk factors such as smoking, diabetes, and high blood pressure
3. Systemic inflammation from any cause (auto immune, dental disease, etc)
3. LDL is a blood test that’s used as a proxy measurement for apob which is the actual risk factor, and doesn’t capture lp(a) which is 4 times as artherogenic as regular ldl. Usually LDL is concordant with apob, but in 20-30% of the population it is not.
You should also note that the PESA trial has shown that plaque can progress in LDL as low as 60. I suggest you look at the PESA website
0
-4
u/blackday44 1d ago
Also, YSK its not only 'old' people that can get high cholesteral. My sister was about 20 when her doctor told her she needed to be more aware of what she ate, or her arteries would be clogged at 30 the was she was going. Kid was eating a dozen cooked eggs a week!
1
-3
u/westondeboer 1d ago
My doctor friends always talk about these types of people.
They run marathons, work out all the time. Look healthy.
And eat like shit.
0
0
1.1k
u/Zafrin_at_Reddit 1d ago
Hey, follow up on the YSK: There is a good measure for the probability of this. It is called Lipoprotein Lp(a). Having it high increases your chance of having clogged arteries even with low LDL.
Lipoprotein Lp(a) levels are circadian-rythm invariant (they just do not change over time at all or oscillate negligibly: one measurement talls you all).