New Study: Higher Cardiac Plaque Calcification in High Intensity Athletes

one piece crank said:
Once I exhausted lifestyle attempts and my PCP’s knowledge to lowered it, I went to a Cardiologist. With the calcium scan, stress test and detailed interview we developed a plan
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This is pretty much how I want to approach it, and hopefully without the statin. The kick in the nuts is that I've been getting my diet/lifestyle in check the last few months so it's a bit frustrating to be up against this. But I've since talked to my parents and brother to gain a better understanding of their histories and it seems like I'm more on the hereditary path vs. lifestyle path.
 
rlb said:
This is pretty much how I want to approach it, and hopefully without the statin. The kick in the nuts is that I've been getting my diet/lifestyle in check the last few months so it's a bit frustrating to be up against this. But I've since talked to my parents and brother to gain a better understanding of their histories and it seems like I'm more on the hereditary path vs. lifestyle path.
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Same. I’ve have an active lifestyle plus a multi-year dive into a plant based diet, but genetics are tough.
 
rlb said:
I've been going down the rabbit hole on this stuff the last few days. I just had my annual and my LDL is through the roof (nearly 200). CT scan for calcium score is in 2 weeks, but I'm doing some reading that suggests calcium score uncovers more advanced artery damage that has been building for a while. The precursor is noncalcified plaques which do not show on a CT scan (but would show on an angiogram, which include IV dye). Based on my bloodwork and family history (dad and uncle both had heart attacks) I'm going to see if my doc will order this test instead.
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Talk with the doc/cardiologist about PCSK9 Inhibitors as well. May have less side effects than statins?
 
I'm also seeing stuff online about coffee impacting LDL, specifically unfiltered coffee (like french press), which coincidentally I drink way too much of. I'm just reacting to initial google results and need to dig in more there. It's tough to separate the legit info from the niche studies that are funded by the likes of the American Society for the Betterment of Tea Drinkers.

Carson said:
Talk with the doc/cardiologist about PCSK9 Inhibitors as well. May have less side effects than statins?
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Thanks, the book I'm perusing mentions this as an alternative so it will definitely be part of the discussion.
 
rlb said:
I'm also seeing stuff online about coffee impacting LDL, specifically unfiltered coffee (like french press), which coincidentally I drink way too much of. I'm just reacting to initial google results and need to dig in more there. It's tough to separate the legit info from the niche studies that are funded by the likes of the American Society for the Betterment of Tea Drinkers.


Thanks, the book I'm perusing mentions this as an alternative so it will definitely be part of the discussion.
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instead of a direct google search, have you tried a couple of different AIs (gemini, chatgpt, grok) and compared results? you can end up in the same boat if they're all using the same sources, but I have found I can usually see some different results and cobble together a better "possible" answer

kinda like (hate to even mention this word) w/ politics, need to read both liberal as well as conservative sources (along w/ "independent" as much as you can trust they aren't biased) and by averaging them all out you get closer to any truth than just using one particular biased source
 
rlb said:
I have not, though maybe I will try. I still prefer the old fashioned reading these days but given the volume of info and the subject matter it might be a better approach.
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I’m with u, prefer to read, and with this approach u’ll still read plenty, depending on what u ask these things they will include links to references…ymmv of course but I’ve found less bias (when using multiple and trying to infer that middle ground truth) than straight google results

Don’t get me wrong, big google fan and user, but there were times it left me wondering how it couldn’t find relevant results for very simple queries.
 
Historicly high bad cholesterol but really good other stuff countered. Had calcium test and was 27 and no statin needed. Finally though, cardiologist, even with very good stress test results put me on lowest 5mg statin which had it holding at acceptable level. But checking a few months ago bad was up to 120 and even though total was 199, he still upped my statin to 10mg. I can't say I feel any difference (or I can't remember....haha). Retesting in a few months and should probably repeat the calcium score test soon, as it's been at least a few years. Ride on!
 
To update this for me - Saw my Dr. yesterday to go over the score and iron out a plan to move forward. After a nice long conversation about alternative ways to lower my LDL we arrived at putting me on a statin. He flat out told me, if I were in my 40's with these numbers he would absolutely entertain a different approach. I'm 62, he want's my LDL from 135 down to mid 70's and basically guarantees that a statin will get me there in 3 months. We did talk about giving an alternative method, diet and supplements (red yeast rice) a shot, but also guaranteed me that in 3 months I would be hard pressed to be under 100. So I'm on Crestor with a review in 3 months to see what my numbers are. Hopefully I don't have the side effects that are reported by some.
 
TommyF said:
To update this for me - Saw my Dr. yesterday to go over the score and iron out a plan to move forward. After a nice long conversation about alternative ways to lower my LDL we arrived at putting me on a statin. He flat out told me, if I were in my 40's with these numbers he would absolutely entertain a different approach. I'm 62, he want's my LDL from 135 down to mid 70's and basically guarantees that a statin will get me there in 3 months. We did talk about giving an alternative method, diet and supplements (red yeast rice) a shot, but also guaranteed me that in 3 months I would be hard pressed to be under 100. So I'm on Crestor with a review in 3 months to see what my numbers are. Hopefully I don't have the side effects that are reported by some.
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My dose was upped from 5 to 10. I too was concerned about side effects. But at 64 hard to tell the difference between a drug side effect and aging.
 
I had my CT scan today and my calcium score came back as 0, which I was obviously really hoping for. So, it seems I am in the clear in some regards. I just need to understand my elevated LDL and what to do about it, which is hopefully not a statin. It was 192, which is crazy to me given my mostly healthy eating and level of exercise. Stress is the one variable I seem to have the least grip on so I've got work to do there.

I never did do a deep dive on the coffee and LDL, but some light research suggests that theory has legs. I've switched to filtered coffee which is supposed to mitigate the risks. I've also been taking berberine and red rice yeast, and today the Mrs. found a study that shows this is effective at lowering LDL. I'll link it here when she sends it over. Also, she found a study that shows people on a keto diet have elevated LDL and no atherosclerosis. While I am not keto, I did spend most of the month prior to my physical eating very little carbs. So I'm hopeful that between the diet and coffee my LDL was a bit of a fluke, and with some changes and supplements it will go down. I'm still planning to see a cardiologist due to some family history of heart disease, and to see what other testing can be done.

One final bit of info, I grabbed this book Outlive: The Science & Art of Longevity which does a great job of explaining the role of cholesterol and the whole atherosclerosis process. It also talks about this one specific type of LDL called LP(a) which basically turbocharges your artery damage, so I'm also looking to understand if I'm impacted there as well. I'm intrigued by the conflicting ways cholesterol is treated. Some guidelines go by LDL/HDL ratio, and by that regard I'm well into the green. On the flip side you have absolute numbers focused on LDL which triggers you as "at risk" and thus on the pharma teat. I tend to view this approach skeptically for that reason, and also because I tend to look at things more holistically vs through a narrow lens. Still, I will talk to a Dr. and see what they say.
 
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rlb said:
I had my CT scan today and my calcium score came back as 0, which I was obviously really hoping for. So, it seems I am in the clear in some regards. I just need to understand my elevated LDL and what to do about it, which is hopefully not a statin. It was 192, which is crazy to me given my mostly healthy eating and level of exercise. Stress is the one variable I seem to have the least grip on so I've got work to do there.

I never did do a deep dive on the coffee and LDL, but some light research suggests that theory has legs. I've switched to filtered coffee which is supposed to mitigate the risks. I've also been taking berberine and red rice yeast, and today the Mrs. found a study that shows this is effective at lowering LDL. I'll link it here when she sends it over. Also, she found a study that shows people on a keto diet have elevated LDL and no atherosclerosis. While I am not keto, I did spend most of the month prior to my physical eating very little carbs. So I'm hopeful that between the diet and coffee my LDL was a bit of a fluke, and with some changes and supplements it will go down. I'm still planning to see a cardiologist due to some family history of heart disease, and to see what other testing can be done.

One final bit of info, I grabbed this book Outlive: The Science & Art of Longevity which does a great job of explaining the role of cholesterol and the whole atherosclerosis process. It also talks about this one specific type of LDL called LP(a) which basically turbocharges your artery damage, so I'm also looking to understand if I'm impacted there as well. I'm intrigued by the conflicting ways cholesterol is treated. Some guidelines go by LDL/HDL ratio, and by that regard I'm well into the green. On the flip side you have absolute numbers focused on LDL which triggers you as "at risk" and thus on the pharma teat. I tend to view this approach skeptically for that reason, and also because I tend to look at things more holistically vs through a narrow lens. Still, I will talk to a Dr. and see what they say.
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I'm going to get my LP(a) tested in a few weeks. I really don't understand why, but it gives a "full picture".
 
So partially prompted by this thread, the other part just my own commitment for 2025 to do more regular health things for myself, I went for an annual physical last Thursday. Generally I don't go to my PCP that much since when I end up with a cold or sinus infection I end up at a walk in place since it's so hard to get a quick appointment with him. But since my PCP is also my Gastro doc, I have some medical history there.

He told me I am much healthier and in better shape than many 53 year olds he sees, especially my RHR and my weight. He and I were surprised my BP was around 130/72 which he said was the high end of where it should be, and last May my BP was 124/68 when they did my vitals for the colonoscopy.

He gave me an order for a full blood panel and said we will do the bloodwork first before we consider if a CT is needed for Cardiac calcium, he acknowledged that based on my high levels of cardiac activity it could be something to check: " unlike a lot of people your age, basically you are doing a stress test every time you ride" were his words. He was fine either way if I wanted to do it he would gladly write it up and review the results. and he did confirm not covered my insurance usually but it doesn't cost more than $100. But first he was interested to see the bloodwork results and see if anything else is a red flag. He mentioned statins but didn't have the opinion that it should be the immediate thing we do which I felt was good as maybe some diet changes, etc... can help. And before we do that, he would send me with the CT results to a cardiologist first to get more feedback.

I've known him for over 20 years and even if I don't go to see him regularly, he knows I used to be around 300lbs at one point in my life, and much less healthy before I started riding 15 years ago so seems for now we are on the same page.

Bloodwork this week then more to follow.
 
iman29 said:
He and I were surprised my BP was around 130/72 which he said was the high end of where it should be, and last May my BP was 124/68 when they did my vitals for the colonoscopy.
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Assuming you were more nervous for the coloscopy appointment 😆 so that result is odd. I had the same slightly high BP at my physical and since my BP is always good, I just shrugged it off as an error. When the BP is not as expected my wife always aske them to re-check it ,I didn't even think to have them check it again.
 
rlb said:
Assuming you were more nervous for the coloscopy appointment 😆 so that result is odd. I had the same slightly high BP at my physical and since my BP is always good, I just shrugged it off as an error. When the BP is not as expected my wife always aske them to re-check it ,I didn't even think to have them check it again.
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yeah good point - i guess I should have asked the nurse what it was and rechecked it. And yes the colonoscopy last may was a bit nerve wracking since I had not gone back for a proper follow up in waaaay too long (see colonoscopy thread) but lucky for me nothing major was found.
 
@rlb

My LP(a) is 12. Redid LDL and it is 112 (down from 118).

Test notes: Values greater than or equal to 75 nmol/L may indicate an independent risk factor for CHD, but must be evaluated with caution when applied to non-Caucasian populations due to the influence of genetic factors on Lp(a) across ethnicities.

Doc says that's good. Above 75 indicates the CV plaque is "stickier" and will build on artery walls more quickly. Doc also noted that while my calcium score isn't zero, he looked at images and it's distributed equally in multiple locations, not all deposited in one spot. So, overall he says just keep doing what you are doing and we'll retest in 5 years.
 
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