Cardiovascular Disease Uncovered – Coronary Calcium Scan

July 29, 2022

It is projected, more than 130 million adults, or 45.1% of the United States population will have some form of cardiovascular disease by the year 2035.1

Early detection and prevention is key to defeating Cardiovascular Disease. By the time many patients see a cardiologist, they have already suffered a cardiovascular event. The last four blog posts reviewed the comprehensive Cardio IQ panel which identifies underlying hidden cardiovascular risks. Assessing your cardiovascular risk before adverse events occur is critical to prevention.

This blog post is a review of a test called a Coronary Calcium Scan and how it can further impact the identification and prevention of your cardiovascular disease risk.

What is Cardiovascular Disease and what are the risk factors?

Cardiovascular diseases (CVDs) are the leading cause of death globally. CVD is a group of conditions affecting blood vessels and the heart. The four most common diseases of the heart are coronary heart disease, stroke, peripheral vascular disease and aortic disease.2 Most CVDs can be prevented! The most important modifiable risk factors for heart disease and stroke are tobacco and alcohol use, physical inactivity and unhealthy diet.

What is the Coronary Calcium Scan (CCS)?

The Coronary Calcium Scan is a non-invasive specialized imaging test using computed tomography (CT) with special software to produce pictures identifying calcium within coronary arteries of the heart. What starts as plaque build-up of fat and other substances stuck in the inner layer of the arteries, hardens over time and becomes calcified.

Calcifications are concerning because:

They narrow the arteries leading to less blood flow and less oxygen to the heart
Pieces of plaque and calcifications can break off and travel as a blood clot to the heart or lungs
They increase the risk of heart attack and stroke.

As more calcifications build, arteries can become completely blocked and blood supply can diminish. The amount of calcium detected on this test is a good marker of Coronary Artery Disease, CAD. In a study of asymptomatic patients, the presence of coronary artery calcium was associated with an increased risk of coronary heart disease.3

Calcification occurs due to inflammation, metabolic factors such as glucose control, oxidative damage from lipoproteins, and imbalanced cholesterol. This is why the coronary calcium scan in conjunction with the Cardio IQ panel offers such a global picture of cardiovascular risk.

What does the Coronary Calcium Score mean?

The amount of calcification on your test is expressed as a calcium score. The higher the number, the higher the risk. A score of zero means no calcium was detected on the test and suggests CAD is minimal or absent and the chance of having a heart attack over the next five years is very low. It is important to note, a score of zero does not mean plaque formation is not occurring, especially among obese individuals, alcohol drinkers and if symptoms are present.4

A positive scan indicates the presence of CAD. As depicted in the following image, a score of 1-10 indicates minimal calcification, 11-100 mild, 101-400 moderate and over 400 high.5

The following image shows what a scan result looks like.6 Depicted on the left is a normal heart with no evidence of calcifications. On the right is an abnormal result showing multiple areas of calcification in white.

Cardiologists use this test to further define cardiac risk

Many patients have no warning signs before having heart attacks or other cardiovascular events. Traditional cardiac work-ups have come up short in identifying risks in presumably low-risk individuals. An American Heart Association publication discusses missed opportunities in cardiovascular disease prevention.7

It is estimated:

20-40% of heart attacks occur in patients not previously diagnosed with CVD
Risk factor and lifestyle modifications can reduce the odds of CVD by 80%
20% of people have undiagnosed hypertension and 30% undiagnosed hyperlipidemia
40-80% of all heart attacks are silent and the heart damage is not found until weeks or months later8,9

Cardiologists are adding the Coronary Calcium Score as preventive testing as it further defines cardiac risk, especially in the asymptomatic patient or those with intermediate risk factors. The test can make a difference in determining treatment options and a prevention strategy.

Treating your Calcium Score

The presence of calcifications and a high score does not secure your fate of having a heart attack. This is a prognostic tool that allows you to take proper measures to reverse any process that has begun. Involvement of a cardiologist is important for moderate to high scores to determine if other tests or measures are warranted.

The first step in addressing any discovered risk is always lifestyle modification including diet, exercise, smoking cessation and reducing alcohol consumption. There are currently no proven pharmaceutical agents that halt, delay, or reverse valve replacement when calcification is present. Calcium supplementation should cease.

Nutraceuticals show great promise in reversal and decreasing progression of plaque and calcification:

Vitamin K2 (MK-7): Associated with inhibition and reduction of calcifications. Adequate intake is associated with lowering of calcium-associated health risks11,12
Magnesium: Higher intake was associated with lower coronary calcium10
Zinc: Higher intake was associated with lower risk of coronary calcium progression13
Omega-3s: EPA and DHA reduce high risk plaque and may prevent calcification and low levels have been associated with early onset of coronary calcium14
Nattokinase: Shown to reduce clot formation, slow and reverse atherosclerotic lesions15
Pycnogenol and Centella asiatica: Shown to stabilize and reduce arterial plaque and prevent the progression to clinical events16,17,18
Vitamin C: Inhibits arterial wall calcification before it begins19
L-Citrulline: Positively impacts hypertension, atherosclerosis, inflammation, type 2 diabetes, and CVD. 20

Coronary Calcium Prevention and Treatment

The foundation of coronary calcium and Cardiovascular Disease prevention and treatment is lifestyle intervention including an organic whole foods diet, exercise, maintaining healthy weight, stress control, supplementation, and adequate sleep.

Addressing underlying inflammation, replacing nutritional deficiencies, eliminating infection and toxins, and achieving balanced omega-3s is essential. Know your risk and take preventative measures now to avoid your number one killer! Coronary calcium and plaque can be reduced. There is no better time than now to initiate simple healthy lifestyle changes.

Have an awesome day! Dr. D

Posted in Cardiovascular Disease, Coronary Calcium Scan