I’m female, 71, have always had high LDL (160ish) and cholesterol (120-140ish) but ratio ok. Asked for ApoB - was127. Peter Attia wants 60 or in older folks with cardiovascular disease in family 30. Came on here to ask re statins and having a CAC was suggested. Just had that done and score is 0. Now what do I do? With such a high ApoB, would you suggest I still lower that? Two other things make me think maybe I should - I’ve been told that I’ve had a heart attack. Some say it’s inconclusive but last person who saw it said I have. (They must be seeing an old echo.) Also I have never been told this but saw on reports I have cardiomyopathy. First noticed it about 12 years ago - said secondary cardiomyopathy, next person said part of heart and last person said in atria. I suppose that’s better than ventricles and don’t know the degree but guess it’s not too bad if no doctor has ever mentioned it.
So I have very high ApoB, possible past heart attack and some atrial cardiomyopathy, but zero plague. Would you go on a statin? My doc is late 50’s and I don’t think keeps up too well so would really appreciate advice from this group. thank you!
Thank God you don’t have the plague it wiped half of the medieval Europe…
but kidding aside… I think the the CAC only picks up the calcified plaque so it may not pick up early atherosclerosis… also what about other arteries in your body, like renal, cerebral or carotid.
Are you dieting, I would definitely cut the BAD* saturated fat under 10 grams a day and ADD omega 3,
5 mg of rosuvastatin goes a long way, it’s super cheap and not a lot side effects with this particular drug at this dose.
Not all saturated fat is bad, it depends on carbon chain length… research it.
Given that you have been told you have had a heart attack and cardiomyopathy - although you aren’t certain - my feeling is you need a cardiologist who you trust.
You mentioned that your current doc (is that doc a cardiologist?) may not keep up too well. At a minimum you don’t seem confident in that person. I would recommend shopping around for cardiologists until you find one you really trust. Then listen to that person’s advice.
General Alarm! Where’s the Mod Squad? By the way…which is worse? Pot? Insane?
“As I say frequently in these forums, go hard on the science, but go easy on the people.” @RapAdmin
There…that should come on automatically, every time the red light starts blinking.
Yes I read about that other test on this forum and wonder why everyone isn’t ordered that. Just went along with this one as really did not expect 0. Does the other test show both or only soft?
Haha I’m sure glad I don’t have that! My diet is pretty good, mostly plant based not much processed or saturated fat. I did realize recently though that the plant based milks I’ve drunk for years have oil in them so switching brands. Ya gotta be so careful. I tend to agree with you Dr. Bart that just 5mg Crestor might not be a bad idea. Someone in last thread suggested adding Zetia to it but thinking with 0 score maybe just see what Crestor does for now.
Hi Betsy, You should try to read up a little on cholesterol. First your LDL-C (160) can’t be higher than total Cholesterol (120), so maybe you have those reversed. ApoB of 127 would normally call for lipid lowering medication (statin, ezetimibe or bempedoic acid) but having a CAC of zero gives you some leeway-but not if you’ve had a previous heart attack. Certainly consulting with a doctor who can look at your other risk factors (blood pressure, insulin resistance, BMI) would be wise because CVD is more complicated than just ApoB or LDL-C. The safe advice would generally be to try a statin - low dose atorvastatin or rosuvastatin with ezetimibe and then keep testing to bring down your ApoB. Also if you can get a CIMT test from a skilled provider, that would tell you about soft plaque. But likely that you should take some action if you think that you have had a heart attack before.
Oh I’ve never been under the care of a cardiologist. I did have PVC’s for a long time that no one paid attention to. Finally did go to a cardiologist Re those and he too ignored them. Finally found a NP cardio specialist who listened and got an ablation. I wonder if they were what the “secondary” cardiomyopathy is from as a friend said they can eventually enlarge the heart. I think my heart is basically fine. I did have some SOB last year and doc had me on a 3 day monitor. Other than 3 short glitches she wasn’t concerned about it was regular sinus rhythm. Likely just stress as pulse ox always fine as well as heartbeat.
Virilius I tend to agree maybe start with just the Crestor - given family longevity genes I could live 20 or more years, enough time for plaque to start forming.
it wiped half of the medieval Europe…
My diet is pretty good, mostly plant based not much processed or saturated fat. I did realize recently though that the plant based milks I’ve drunk for years have oil in them so switching brands. Ya gotta be so careful. I tend to agree with you Dr. Bart that just 5mg Crestor might not be a bad idea. Someone in last thread suggested adding Zetia to it but thinking with 0 score maybe just see what Crestor does for now.