My Calcium Score is Zero (And Just Why is That Good?)

I’m not a doctor, and I don’t play one on TV, so what I’m about to talk about is strictly my opinion, drawn from my own experiences. But all of us have heard this story—the one about the guy (or gal) who dropped dead from a heart attack in his 40s or even younger. He didn’t smoke, wasn’t overweight, had low cholesterol, ate sensibly, and ran four miles a day. He went for regular checkups, always passed a stress test, and had absolutely no signs of heart disease.  According to the 2015 film, The Widowmaker, there are 600,000 deaths per year due to sudden heart attacks in the U.S. In 25% of those cases, the victim had no signs or symptoms of heart disease.

What if I told you a simple test could determine whether you are at risk for a heart attack? Would you take it? What if I told you the average price for this test is $100 to $150 and must be paid out of pocket? Would you spend the money? I just did.

The test I’m referring to is called a CT heart scan with calcium score. It’s not new. In fact, it’s been around for decades. It’s a simple scan, where you lie down on a table with your arms over your head. The table slides you into a donut-like machine which is equipped with speakers. You’re instructed to hold your breath three separate times while various images of your heart are taken. And that’s it. (The CT heart scan shouldn’t be confused with the CT angiogram which is more invasive.)

One of the most straightforward pieces about the CT heart scan is an interview at Every Day Health with Dr Arthur Agatston, the South Beach Diet doctor. I had no idea that Dr. Agatston is a renowned cardiologist. And he was the one who invented a quantifiable way to view the results of the CT heart scan—thus, the calcium score. Dr. Agatston explains that we should be watching for signs of plaque near the heart, which is evidenced by calcification in the arteries. The more coronary calcium, the more atherosclerosis (hardening or narrowing of the arteries). The CT heart scan detects calcification (or lack thereof) and a value or score is assigned to the results. Dr. Agatston says  “thousands of studies”  have created a “mountain of evidence” that the calcium score is the single best predictor of a future heart attack.

So how did I do? I scored a zero, which in this case is the best possible result. Zilch, nada, none—no calcification. Ipso facto—no heart disease. And I scored a big fat zero, even when my cholesterol level, when left to its own devices (i.e. not taking meds) is above 300! And what if my calcium score had been high? Most likely I’d go back on medication to avoid a future heart attack.

Let me back up and explain why I went for this test. For over twenty years I’ve been on cholesterol medication. A cholesterol level of 300+ is extremely high. Prior to going on medication I tried various methods for lowering my numbers. I was already fit and eating well but I tried flax seed, measuring all my food, etc. but the numbers only slightly budged. After two doctors unsuccessfully attempted to get me on statins (one of the most common classifications of cholesterol lowering drugs), I was convinced by the third. And I’ve been on 10 mg of Lipitor (now the generic, atorvastatin) ever since. That is until my last physical three weeks ago, when I quit cold turkey the day before my doctor visit.

My parents, now deceased, both had high cholesterol. My brother has high cholesterol and his sons, my nephews, had high cholesterol as infants. It’s safe to say I’m genetically predisposed to it. However, there is no heart disease in my family. But my parents were of the generation that followed the doctor’s orders without question—they were on statins long term and had no qualms about it. I, on the other hand, have always been frightened of using statins. There is no rock-solid long term study on the effects of statins on the body. I never had any side effects I was aware of but I began wondering what the drug might do to my brain—because on that front, there is disease in my family. My mother had dementia and my father had Parkinson’s disease. Many experts are concerned that statins may cause cognitive impairment—even the U.S. Food and Drug Administration has issued a warning about it. With two strikes against me I became more and more worried about remaining on atorvastatin for the rest of my life.

Mr. Groovy and I began reading about nutrition last year. In the book “The Big Fat Surprise,” investigative journalist Nina Teicholz shows why everything we thought we knew about dietary fat was totally wrong. She offers proof that foods rich in saturated fat and cholesterol are not harmful to us. She also exposes the politics behind the field of nutrition and shows how Americans were duped by federal policy, which manipulated us into believing we should be on low-fat diets—a policy move which was based on BAD SCIENCE. And the truth was withheld on purpose.

Much of what some people call the Diet Mythology, or the opinion that cholesterol and fat in the diet lead to heart disease, can be traced back to Ancel Keys (founder of the K-rations) in the 1960s. His famous “Seven Countries” studies was used as proof that there was a connection between deaths from heart disease and a high cholesterol/high saturated fat diet. But Nina Teicholz, and others who have pored over the studies and results, insist that Keys cherry-picked his evidence to validate his theories. Many Americans have changed the way they eat, based on dietary recommendations conjured up in the 1980s that were based on BAD SCIENCE.

To be fair, many people in the medical community are not proponents of the CT heart scan and calcium score. Some feel that marketing this specific test directly to consumers is dangerous. Dr. Steven Nissen of the renown Cleveland Clinic is one of them. He’s interviewed in the 2015 documentary The Widowmaker, which shows both sides of the coin—although make no mistake, the filmmaker’s point of view is very pro heart scans.

The seemingly healthy person who dies of a sudden heart attack may have low cholesterol, but may also have advanced narrowing of the arteries. For 150,000 people who die of sudden heart attacks yearly in the U.S.—that fatal heart attack is the first (and the last) sign of heart disease. The CT heart scan with calcium score might just prevent that heart attack from happening. There must be a preponderance of evidence leaning in that direction because, according to The Widowmaker, all astronauts entering the NASA space program are required to be tested and to have a zero score.

Those in favor of heart scans believe cholesterol levels are not particularly important. They also feel that cholesterol meds and other interventions are big business for the medical community. The Widowmaker shows how angiograms and  “stents” are overused by heart surgeons. Stents are used in angioplasty, a procedure which opens up the arteries. An angiogram is a testing device used to detect blockages of the arteries. Angiograms are invasive and may lead to unnecessary bypass surgery. The Widowmaker claims that 50% of the angiograms given at the Mayo Clinic are unnecessary! An article in the Wall Street Journal about a study published in the New England Journal of Medicine, says 62% of the patients used for the study’s data showed no sign of heart obstruction.

So why am I writing about this now and on this blog? Well if you follow Mr. Groovy and me, you know that we’re planning on retiring in six months. Our “Cadillac” health insurance will disappear and we’ll go on Obamacare. We’ve put ourselves in training for retirement: we walk two miles almost every day, Mr. Groovy does his home gym routine three times a week and his Miracle Morning every day, and I do my 15-minute shoulder routine every morning (my shoulder began to hurt badly, out of the blue, six months ago). We want to travel in retirement. We want to do physical activities around our new home, i.e. build Mr. G’s outdoor oven so he can bake his bread. And if we don’t have our health—well, then our plans will be seriously altered.

The Society for Heart Attack Prevention and Eradication (SHAPE) has a vision to free the world from the threat of heart attack and stroke. Its guidelines encourage all men 45 and older and women 55 and older to undergo the CT heart scan. Dr. Agatston advocates these guidelines as well. As I mentioned earlier, Dr. Agatston states that the CT heart scan is the single best predictor of a future heart attack.

So I ask you Groovy Freedomists—if you’re a male age 45 or older, or a woman age 55 or older, would you consider getting a CT heart scan with cardiac score? It just might be the best $100 bucks you’ve ever spent. And it also just might save your life.


Further reading and additional resources:

Books

The Big Fat Surprise by Nina Teicholz

Good Calories, Bad Calories by Gary Taubes

Why We Get Fat by Gary Taubes

The Great Cholesterol Con by Anthony Colpo

Eat Fat, Lose Fat by Dr. Mary Enig and Sally Fallon

Articles

Fallacies in Modern Medicine: Statins and the Cholesterol-Heart Hypothesis

Will the Right Tests Keep You From Having a Heart Attack?

Harm Outweighs Benefit When Cardiac Tests Are Marketed Directly to Consumers

Heart Test May Be Overused

The Framingham Flip Flop

FDA Expands Advice on Statin Risks

Serum Cholesterol Values in Patients Treated Surgically for Atherosclerosis

What are the risks of ‘coming off statins’?

Other

Society for Heart Attack Prevention and Eradication (SHAPE)

Film “The Widowmaker” from 2015. Available on Netflix or for rent.
Here’s the trailer: http://widowmakerthemovie.com/
And a review http://www.rogerebert.com/reviews/the-widowmaker-2015

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15 Comments

  1. Wow, I had no idea about this test. If I could go back now, I would have had it ten years ago (if they had the test ten years ago) before my heart attack and congestive heart failure. Unfortunately I wasn’t much for going to doctors back then, and now I’m dealing with the results. It’s interesting what you say about stents. I had one stent put in after the original heart attack, and then two years ago they wanted to do another and I said no. I went home, changed my eating and exercise habits, took the medications recommended and drastically improved my heart health without surgery. Since then I’ve lagged a bit, but my point is that surgery isn’t always the answer, and that much (though certainly not all) of what happens to us is within our influence.

    You’re very smart to be considering all of this now, before it’s a problem. I wish I were healthy enough to do all the activities I want and to spend less money on my healthcare. It’s important to invest in your own health before it’s too late and $150 seems a small price to pay.

    • Mrs. Groovy

      And YOU were very smart not to do another stent, Gary. Check out the Widowmaker if you can. The film makes the point that too many stents may result in a patient no longer being a candidate for bypass surgery. Granted, I hope you never need that, but to my way of thinking, bypass surgery is life saving and can have permanent lasting effects. If I had a heart condition I wouldn’t want to take that option off the table should I ever need it.

      Right after I saw my doctor I learned our affiliated hospital was offering the CT heart scan for $99 during the months of February and March. Normally it’s $149. After confirming I didn’t need to let more time pass to get the meds out of my system, I was able to get an appointment on March 31st.

  2. And you didn’t sleep at a Holiday Inn Express last night?

    “We want to travel in retirement. We want to do physical activities around our new home … if we don’t have our health—well, then our plans will be seriously altered.”

    Indeed. Now that our financial plan is largely on auto-pilot, the wife and I talk more often about our physical health – diet and exercise – than we do about managing money. Like you two, being in a position to enjoy or financial freedom in retirement is paramount.

    CT heart scan … great share.

    • Mrs. Groovy

      No, I wasn’t smart enough to sleep at a Holiday Inn Express last night!
      …Right, enjoying financial freedom in retirement is paramount. And good health is the most important part of the equation. It’s great that you and your wife discuss your physical health. It takes a little planning to make sure our bodies continue to support our lifestyles.

      Thanks for reading and commenting, James.

  3. Miss Jaime

    So I don’t have to become a vegan to be healthy? That is a huge push from the diet and health industry right now. They are trying to guilt you really badly right now about being an omnivore.

    They’re saying that you’re ethically evil for eating meat, it has turned me off from veganism.

    I’ve really been resisting this whole anti-meat movement. Something seemed amiss about it. I suppose it’s because my grandmother lived in Russia in a village and ate meat, butter, cheese, eggs, and made really fattening dishes too.

    Like she made this bread full of butter & cheese. It’s similar to Georgian cheese bread. I swear it has to be at least like 700 calories. Not all the time but like once a week. My mom makes this bread and stays with tradition, she makes it once a week, lol. However my mom is a health nut so she balances it out.

    Anyway granny was thin and she lived until she was 80. She had some health issues but it’s not as bad as what you see now with a lot of the elderly. She also looked like a young eighty year old, didn’t have a lot of wrinkles.

    You’ve got me curious now I want to read big fat surprise and see widowmaker.

    • Mrs. Groovy

      The bread your granny made sounds amazing. I love bread, muffins and especially scones and bagels. But I’ve cut down on all that now that Mr. G has been doing so well with a higher fat/higher protein diet.

      A cousin of mine and his wife decided to bring their kids up as vegans but their pediatrician put a stop to it. He told them their diet was stunting their growth. Meanwhile I do recall they put gobs of oil in everything they cooked so how healthy is that?

      That whole meat-eaters are evil thing is something I don’t have the tolerance for. It feels the same to me as people who ring my door bell trying to talk to me about religion. They’re entitled to their beliefs as long as they don’t shove them down my throat.

      I found “The Big Fat Surprise” in our local library so you might find it in yours. The author, Nina Teicholz, also has a TedTalk: http://tedxtalks.ted.com/video/Nina-Teicholz-at-TEDxEast-The-B

  4. We asked our Dr. about this test and he just totally dismissed us (for my husband). He was on cholesterol meds for 10 years and had terrific arm pain. Now off the meds, no pain at all. He takes Niacin now instead and the Dr. is monitoring. We are looking for a place that we can get this scan done now too.

    • Mrs. Groovy

      Vicki, I’m not surprised at all your doctor dismissed you. I was lucky. I see a nurse practitioner that’s part of a large medical practice associated with our hospital system. When I asked her about the test she was the one who told me the hospital was running a special on it that month and charging $99 rather than the full price which I believe was $149.

      The scan has been around for decades so I hope you can find a place nearby that offers it. I know a few people that have had good results with niacin. I had no physical side-effects I was aware of from Lipitor, which is probably why I waited so long to get off of it….I don’t know your husband’s health circumstances but if he has any known risk factors, even if he has a zero calcium score, you still should consider him staying on the drug. Assuming he’s on a Statin of some sort there seems to be proof that it’s necessary for those with risk factors (high blood pressure, history of heart problems or heart problems in family, diabetes, etc).

      Unbelievable timing, but Mr. G just received a call this morning about a friend whose wife died of a sudden heart attack at 51. She had no known problems or risk factors. She got in a car with her 8-year old and slumped over as she started the car. (The boy is fine). Under these circumstance they won’t do an autopsy so there’s no way of knowing, but it’s possible she had calcification and problems that would have shown up on a scan. The scan isn’t a totally conclusive, be-all, end-all fix — but it’s a tool that IMO should be used, in conjunction with other medical care.

      P.S. It’s interesting to read up on cholesterol and the myths surrounding it, and the whole low-fat craze.

  5. Great share about that scan. I’m a huge convert to eating low carb, high fat. Probably because I go against the grain. Everything I read in books, articles, and blogs tells me that our food pyramid is wrong (thanks a bunch Mr. Keys).

    In addition to your list of references, check out Jimmy Moore (great podcasts and books, one called Cholesterol Clarity) and DH Kiefer (books Carb Nite Solution and Carb Back Loading). I live by Carb Nite now in order to lose weight, all fat loss. Amazing results for me. The key for me is high fat and moderate protein.

    I drive my wife nuts talking about this stuff. I’m finally getting her to see things my way and she is cutting back on carbs slowly.

    • Mrs. Groovy

      Jimmy Moore is the Vida Low Carb guy! I’ve seen a few of his podcasts. Mr. Groovy lost app. 30 pounds on low carb and he wasn’t really heavy to begin with. Now I have to make sure he eats enough. Once I told him that pork rinds are high fat/low carb he got hooked on them. Unfortunately sometimes that’s all he wants for lunch. I lost around 6 pounds but I was killing myself and I crave bread. I give in to high fiber/whole wheat bread but still stay away from potatoes. We also cheat a bit with pasta and rice although when I make spaghetti I do half zucchini with one of those spiral-izers.

      Thanks for the tips. I’m going to check them out, especially the Cholesterol Clarity book for me and Carb Nite for Mr. G.

      Of course my doctor wants me to come back for another cholesterol screening being that I went off the drug but I’m sticking to my yearly checkup. I already know it’s going to be high.

    • Mrs. Groovy

      P.S. I meant to point out “I go against the grain” ha ha. Was that on purpose or did you go Freudian?

  6. Totally agree about the cholesterol medication. Couple of other books I would recommend
    Bad Pharma – Ben Goldacre
    Bad Science – Ben Goldacre
    The Great Cholesterol con – Malcolm Kendrick

    Base message would appear to be, is if you’re a male in your 50’s with previous heart problems – statins work for you. The rest forget it!

    Must try and find out if we can get the CT scan / calcium test in the UK. Like you, I want a long and healthy retirement.

    • Mrs. Groovy

      I’ve heard of Bad Pharma but I’m not familiar with the author. Thanks, Erith. I’ll look into those and The Great Cholesterol Con.

      A foot note to my post: I went back for a blood test around 4 months later. My cholesterol rose to 275 (it was usually around 170 on the meds). But all my ratios (hdl/ldl, etc.) were good. My doctor said because I scored a zero on the scan and my ratios were good, she was not recommending that I go back on the meds. I was determined not to go back to them either way but I was expecting to have a struggle with my doctor.

  7. I am a cardiologist and have no problems with calcium scores. I think they are good screening tests and can be used to determine if individuals are at low or high risk for a heart attack. It is great to get people motivated to make lifestyle changes and if needed be on medicines like statins (there is some negative studies out there like you mention but there is way more long term studies demonstrating the benefit in decreasing heart attacks). I would caution against using the Ct scan as the end all be all.

    Additionally what if you had a high calcium score? Would it lead to unneeded worry and stress?

    • Mrs. Groovy

      I respect your opinion, DDD, and thank you for adding to the discussion. I agree with you about the test being a mere tool, and not the be all end all, which is why I made certain to include opposing views. I feel individuals need to make their own decisions depending on their medical circumstances and the advice of their doctors. I’m thin, have no heart disease in my family, have low/normal blood pressure (110/70), and walk two miles every day. I feel there’s not a large enough body of work regarding the long term effects of statins, or whether they play a part in dementia. If my calcium score had been high though I certainly would have had more discussions with my doctor about staying on the Lipitor.

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