So how do I follow up on last month's blog by Dr. Johnston on the joys of sex??? Well, to have sex, you have to have a healthy heart and that’s where the discussion on calcium comes in.
The presence of calcium in the arteries of your heart is evidence of plaque, and that’s not a good thing. So, how can we look at that? Fortunately, there is a simple, painless, non-invasive test called a "coronary artery calcium score CT". Many facilities offer it for a nominal charge, including here in the Valley. Some as low as $50.00.
If you are in your 40’s or older, then this test may be for you. We are trying to find ways to assess risk of heart disease. There are several factors that can determine your risk, including: family history, smoking, abnormal cholesterol, high blood pressure, being overweight, sedentary lifestyle, etc. However, none of these tell us for sure whether you actually have evidence of heart disease. But, the coronary calcium score can. Essentially, if your coronary calcium score turns out to be zero, indicating no evidence of plaque, then your risk of having a clinically significant heart disease in the next few years is extremely low.
Does that mean you should eat McDonald's daily, ignore your blood pressure and continue to smoke? Absolutely not! We know that all those conditions are associated with other significant medical problems other than heart disease, such as cancers, strokes and kidney disease. But maybe it would result in eliminating the need to take cholesterol medication or keep you from starting it in the first place.
We know that elevated cholesterol is a risk factor for heart disease, but not everyone with high cholesterol gets heart disease. Contrarily, some folks with normal cholesterol, do get heart disease. Again, the coronary artery calcium score CT may help me determine who to treat in regards to cholesterol. If you have diabetes or have already had a heart attack or some other test like a cardiac catheterization that has found heart disease, then you don’t need this test. We already know you have heart disease, and this test would not be helpful.
Another result of this test is that of an elevated calcium score. This could indicate mild to extensive amounts of plaque in your coronary arteries and therefore put you at a much higher risk for a heart attack in the next few years. The higher the calcium score, the more extensive the plaque, the higher the risk for having a heart attack. In this situation, we would want to be very aggressive in reducing your risk, so you may be started on new medications for your cholesterol or even increasing current dosages to drive down the bad cholesterol (LDL) even lower than before.
Obviously, this test is not for everyone. You may not need it as it may not make a difference in your care. Who should know the answer to that? Your doctor, of course. Ask questions. That’s what we are here for.
Dr. Matt Oetken
Family Practice