With no apologies, another bit of Attia wisdom…
“Talking about me”, in that I’m hopefully one of those people who’ve been dealt a craptaculous genetic hand with regards to ASCVD who stand to benefit from the sort of discoveries that’ve lead to the development of PCSK9 inhibitors (for but one example)
Obviously a topic that has broad METAR implications. Well, I hope so anyway
VeeEnn,
Sorry to hear this or see it for the first time more clearly.
I actually was very worried about myself in this. In 2019 I had a calcium scan for my chest arteries. I have a calcium score of 163. A few months ago I went to a cardiologist. He brought up the scan and looked at the time lapse video. I have no plague. My legs are clear as well. I use K2 MK7 to ward off any chance of osteo after age 70. Dad does not have osteo but mom does. Also I do not want the calcium score to rise and rise unnecessarily.
My decade of 6.7 A1C has done no damage to my arteries as far as plaque goes. I am lucky.
My cholesterol and BP are in fantastically good shape. My family history is next to no heart disease nor cancer.
My next weight loss is a bit more for vanity.
A bit more nuance surrounding ASCVD risk and personal risk assessment
This is probably your best reassurance with regard to ASCVD…provided your family contains enough folk who’ve made the same risk enhancing lifestyle choices that you have, of course. It is totally possible…possible but not likely…that the genetic hand you’ve been dealt is so protective that you’re set for longevity regardless of what you do.
Are you sure that you actually had a CAC scan…or was it a CT angiogram? My husband has a very fancy version of the latter every 6 months as a follow up to his surgery…this has an imaging technique that presents on the screen as almost a moving 3-D image.
CAC scans don’t use the same technology. I actually asked my cardiologist on Monday if there are objective, non invasive ways to detect/measure progression or regression of soft plaque. The answer is no (disappointing for me…I don’t want to just imagine my aggressive therapy and super duper new lipid profile is doing the trick) Apparently, absence of evidence isn’t evidence of absence in that it’s possible to visualize existing plaque if the burden is heavy enough and calcification is not that great yet …but the very early, more vulnerable lesions typically don’t show.
As you might’ve read if you followed the hyperlinks, your coronary arteries (along with others) don’t just acquire a calcium burden “unnecessarily”…as in for no good reason. Calcium deposits build up as part of the maturation and stabilization of early atherogenic plaques…not some sort of defect in calcium metabolism. I’ve seen this sort of guff associated with the marketing for these K1 supplements and it’s hugely misleading and seems to me to add more to the myths surrounding ASCVD than it does to cardiovascular health.
So reading Dr. P’s article in full, I had to smile a bit…especially when it came to “Lisa” and the plant based diet towards the end.
Among other pertinent questions, my cardiologist always checks in on my exercise regimen (it’s hard work to talk over my husband’s efforts to portray me as an exercise fiend) Giving details, he fully approves
…and actually asked me for a few references this week. Diet next…again dh feels the need to interject “You know we eat a healthy diet … I don’t get to have the things Iike”…chortle, chortle. So, my man turns to me and asks if it’s a “plant based diet”. “Nah”, sez I " more Mediterranean…we went to Crete on our honeymoon. Discovered I liked it then" Also mentioned how these “Fork Over Knives” types are closet vegans…aggressively anti fat. Even olive oil. Seemed disappointed and then explained why.
Seems his wife is a clone of me. Has been on a lipid lowering regimen of statin+PCSK9 inhibitor but has just discovered this plant based diet guff. It’s apparently all fish and vegetables in their household (wouldn’t bother me too much) now…hardly so much as a shred of chicken.
I think dh has appreciated how lucky he is with me.
Honestly VeeEnn,
Even if I could well answer the question the doctor I saw was clear I do not have plaque. Your situation may need more information than mine. No plaque is probably easy to call in any of these tests.
As far as longevity based on plaque etc…that is not my problem at age 60. I have a good running start.