A follow on from my previous question about Kraft tests (link omitted, I seem unable to post links). I am a type-2 and I am concerned about possible future cardiovascular disease. My GP suggested I take statins, although my cholesterol levels have since improved.
I've heard about the calcium score test from the video A Cardiologist's Low Carb Journey by Dr. Jason Kaplan on the Low-carb Down-Under YouTube channel. (Also about the disconnect between cholesterol and CHD, but that's another topic.)
To summarise the video:
Arteriosclerosis is a precursor to coronary heart disease (CHD). It is when macrophage foam cells scavenge damaged ("small-dense") LDL particles, causing high-cholesterol lipids to pool between cells, which starts to caclify over time. The rupture of these calcified plaques are the immediate cause CHD. This process is gradual: it takes many years, but often starts in your 20s.
Currently, statins are the drug traditionally prescribed as knee jerk reaction to high blood-lipid cholesterol measurements. They can have adverse side effects. But, if you don't have arteriosclerosis, you do not need statins.
A calcium score test is a low radiation CT scan, lasting ~10 seconds in duration, which can be used to measure the calcification of arteries. It costs $100-200 AUS, no specialist referral is needed, and generally can be obtained from any large radiology provider.
A CS test allows identification of those who, despite high cholesterol, do not need statins. This is is reasonable measurement to make for:
If your CS shows you don't have AS, and your doctor suggests taking statins, you should show them the very limited benefits of statins for low-risk people.
The take-home: if your 10 year CVD risk is <= 10% or your calcium score is <= 75%, then statins give far more limited reductions in CVD risk compared to diet and lifestyle changes.
I seem to check the boxes in the criteria above. But there's not much info I can find about this test. These are the questions I'd like to ask:
I've enquired, but in the mean time I wanted to ask the forum what is known about this? Perhaps someone here has investigated and even had such a test?
I've heard about the calcium score test from the video A Cardiologist's Low Carb Journey by Dr. Jason Kaplan on the Low-carb Down-Under YouTube channel. (Also about the disconnect between cholesterol and CHD, but that's another topic.)
To summarise the video:
Arteriosclerosis is a precursor to coronary heart disease (CHD). It is when macrophage foam cells scavenge damaged ("small-dense") LDL particles, causing high-cholesterol lipids to pool between cells, which starts to caclify over time. The rupture of these calcified plaques are the immediate cause CHD. This process is gradual: it takes many years, but often starts in your 20s.
Currently, statins are the drug traditionally prescribed as knee jerk reaction to high blood-lipid cholesterol measurements. They can have adverse side effects. But, if you don't have arteriosclerosis, you do not need statins.
A calcium score test is a low radiation CT scan, lasting ~10 seconds in duration, which can be used to measure the calcification of arteries. It costs $100-200 AUS, no specialist referral is needed, and generally can be obtained from any large radiology provider.
A CS test allows identification of those who, despite high cholesterol, do not need statins. This is is reasonable measurement to make for:
- Men over 45, or over 40 when more then two cardiac risk factors present (hypertension, diabetes, cholesterol, smoking, strong family history)
- Menopausal women, or similarly earlier if risk factors present
- Anyone with an arteriosclerosis/cardiovascular disease risk score of 5-20%
If your CS shows you don't have AS, and your doctor suggests taking statins, you should show them the very limited benefits of statins for low-risk people.
The take-home: if your 10 year CVD risk is <= 10% or your calcium score is <= 75%, then statins give far more limited reductions in CVD risk compared to diet and lifestyle changes.
I seem to check the boxes in the criteria above. But there's not much info I can find about this test. These are the questions I'd like to ask:
- Is the Kraft test available on the NHS? (I live in Scotland)
- In not on the NHS, where?
- When private clinics offer it, what does it cost?
- Why do GPs not know about it?
I've enquired, but in the mean time I wanted to ask the forum what is known about this? Perhaps someone here has investigated and even had such a test?