Question

Asked 5 years, 2 months ago

Here are my numbers. How healthy is my heart?


I'm 52, 5’ 10“, and 150 lbs. In 2001 I had a CT scan to check for plaque build-up on my heart, and my cardiac calcium (CAC) score was 14. In 2008 my doctor insisted I repeat it and now it's 114. My lipid profile is excellent, though, with a cholesterol of 179, HDL 93, LDL 72, and triglycerides 71. I run three times a week at fairly high intensity (my HR often reaches 170 or higher). I bike twice a week for about 45 minutes and lift weights regularly. I also race, I have no symptoms, and my only risk factor, as far as I can see, is my parents' cardiac history. My mom and dad had coronary heart disease, which they acquired fairly early in life, but neither exercised or ate well. Both smoked and one was an alcoholic.

My cardiologist, who did not think a statin was necessary, gave me a stress test and advised that I take a baby aspirin daily. The stress test went well (10:50 at 18 METs) and the only finding was mild mitral and tricuspid regurgitation at rest and post-exercise. My blood pressure is normal, and I watch my sodium intake. My diet is mainly Mediterranean, with 8 to 12 ounces of wine daily. Since this recent CAC score I've added (almost every day) either fish or fish oil in 2-gram amounts.

Now that I understand a little more about coronary heart disease, was there any point in getting that repeat CAC, with all the attendant radiation? I had plaque then and some more now. From what I can see that's all it tells me. Does it matter whether it's 14 or 114 or 214?

Also, I wonder whether the stress test was of value. Polar states their monitors are 98 percent accurate. So my max rate should be above 180 just looking at my numbers from training. The stress test was based on the 220 minus my age formula, which I questioned at the time of the exam. I only reached 169. It was a very hard effort but it was not natural, that is, I think I could have gone on but the limiting factor was the extreme grade. I felt that my legs might give out and I'd fall off. Is this a common complaint of someone like me who achieves higher heart rates with pace over longer periods? Do other protocols manipulate variables more familiar to the athlete (treadmill testing using faster paces rather than extreme grades). Even if 185 is my max heart rate, is achieving 169 adequate? Or was the whole idea of a test pointless because I've given myself a stress test three times a week for 20 years?

Two other quick questions, on my supplements: Is taking aspirin helpful? What about the two grams daily of fish oil? Are there any risks that might offset the cardiac benefits? I just found out on a brain MRI (they were looking for an acoustic neuroma for complaint of tinnitus) that I have a venous angioma (with no cavernoma/AVM). Does that change the picture with regard to the use of aspirin and omega-3 supplements?

David Whittier
Reseda, CA

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