Heart month is coming to an end and by now I hope you have worn a red shirt to work, joined a walking club, participated in Meatless Monday, and took the Simple 7 calculator. As we move into March (colorectal cancer awareness month), have you really advanced your knowledge of the no. 1 killer in the Western world? Recent data indicate that unless you have had one examination of your heart, one single affordable test, you have not found out whether you are walking around with silent heart disease or not. So what do you need to do?
One new study was just published comparing multiple measures of heart health in patients with symptoms suggesting heart disease and risk of heart attack. In over 5,000 subjects studied, male gender, smoking, diabetes and high cholesterol were predictive of finding a significant narrowing on a heart catheterization. However when a heart calcium score was added to the analysis, it rose to the single most accurate predictor of a blocked heart artery. So you can have high risk by "risk factors" for heart disease, but if your heart calcium score is zero, you have a small risk of a significant narrowing. On the other hand, if your heart calcium score is high, even if your risk factors seem low, your chance of a serious blockage is high.
In a separate study of over 6,800 patients of a diverse background, various means of predicting heart disease were compared. A risk score was predictive of the 10-year risk of developing heart disease, but when the heart calcium score was added in to the assessment, it improved the accuracy and was the most predictive of all the measures.
So what is a heart calcium scan? It is a simple CT of the heart performed without injection of any materials that permits the easy identification of calcification (plaque) in the three heart arteries. By good fortune, the density of arteries is different than the fat they sit in and the muscle and blood that are nearby in the heart. Calcium comprises about 20 percent of plaque in arteries but is such a different density than the rest of the heart that even small amounts show up like a beacon of illness without exercise, IV placement, or sedation. A software program permits a score, called the Agatson score, to be calculated with zero being the best result and numbers in the tens, hundreds and even thousands indicating increasing burdens of calcified heart artery plaque.
Research studies like those cited above indicated that the heart calcium score is the most accurate way to detect silent heart disease and also the strongest predictor of future cardiac events like heart attack and death. In my area the scan can be done for as little as $75 so there is easy availability to all who do not know they have early heart disease but want to find out.
If you have not heart of a heart calcium score it may be because it has not been promoted as much as more expensive and invasive stress tests and heart catheterizations. This dilemma is the focus of a provocative and must watch documentary called The Widowmaker. Although you may need a prescription from your health care provider, after watching this documentary, I am quite certain you will conclude heart month knowing your heart calcium score. I know mine and it is zero.