What is a coronary calcium scan and is it worth it?

Regular readers of my column know that I am very optimistic about the Coronary Calcium Screening, also known as the calcium score test or coronary calcium score as a heart disease risk test. I take my leadership from Dr., a cardiologist who has been advocating this case for several years. I got it from Henry Sadlo.

CCS has been instrumental in saving many lives, and another reader recently wrote to me to tell me about her experiences with the test.

“I was at home watching TV with my wife when I felt a sharp pain in my chest. Shortly after, the pain went down to my left arm as well, while my wife said I had to go to the hospital.” reader wrote. “I did, and they did tests on me multiple times during the night, but they couldn’t find anything wrong. The results were that it must have been heartburn or gas.”

“The information has been added to my online chart and personal information. [doctor] He had seen and called me for years, insisting that he see me immediately. When we met the next day, he told me that he was not convinced that nothing had happened and that he had already arranged for me to take a CCS exam,” the reader continues. My CCS score was over 800, alarmingly high, and even worse, there was a problem with the so-called ‘widowed’ artery. An appointment was made with the cardiologist for the next day. Two days later, I had heart surgery with two stents.”

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The reader continued: “If I didn’t have a personal experience [doctor] someone who cares so much about my well-being and knows the benefits of CCS, there’s a good chance I’ll have a major heart attack soon and not write about it. I am deeply indebted to my doctor and thank you and Dr for drumming in this non-invasive procedure that saved my life. Thank you Sadlo.”

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What is the cost of Coronary Calcium Screening and is it covered by insurance?

Let me clear up some confusion and concern about why CCS isn’t covered by most health insurance.

It is normal for new tests to take quite a long time before they are accepted for insurance payment. There are many reasons for this, including the fact that new tests often mean additional expense and that it’s a natural business decision to resist new expenses for as long as possible until the evidence is overwhelming that certain tests should be treated as part of “basic” health care.

The out-of-pocket cost of CCS varies, but is around $100. The above letter and the many testimonies of Sadlo’s patients make it clear, I think, that the money is well spent.

Another hurdle is that CCS measures calcified plaques in the heart arteries. Plaque first builds up in the arteries as a “soft mass” of cholesterol and other debris. Over the years, calcium invades these flaky plaques and glues them in place, hence the term “hardening of the arteries.” The problem with evaluating CCS results is that you may have significant blockages in your arteries that are still mushy and cannot be detected with CCS.

In turn, this can provide a false sense of heart health with a CCS score of zero.

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But despite this limitation, CCS testing is still an extremely valuable tool. Moreover, almost all tests have some limitations. For example, the blood pressure in my arm may be very different from the tension in my ankle. If so, it could indicate serious vascular problems. So does that mean it’s not worth measuring the blood pressure in my arm as it says nothing about what’s going on in my ankle? Or does it mean that this limitation needs to be noted and additional steps taken? The answer is obvious.

Does resistance and strength training help reduce heart disease?

For over 50 years of my career, cardio exercise has been the highlight when it comes to promoting cardiovascular health and prolonging life. Resistance training with dumbbells has always been an “add-on”, so first make sure you do your cardio training regularly according to established guidelines. This includes at least 150-300 minutes of moderate-intensity exercise (walking) or 75-150 minutes of vigorous-intensity exercise (running, cycling, swimming, elliptical, etc.) per week. Then do a few resistance workouts to keep your muscles from breaking down.

This is changing as resistance training gains a new and improved status. Several recent studies, including a study published Sept. 27 by the “British Journal of Sports Medicine,” suggest the health benefits of resistance training, and a new large-scale study takes the point home. Since 2006, approximately 100,000 people, men and women aged 55-74, have been followed by frequent surveys and deaths from all causes (cancer, etc.) as well as from heart disease (the number one killer) have been recorded.

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Exercise habits among subjects are typical for the American adult population, of which 23.6% meet cardio guidelines and 16% regularly engage in resistance exercise. Not surprisingly, those who exercised regularly had the lowest risk of death. Surprisingly, however, those who limited their exercise to resistance training showed only a 9% lower risk.

Is cardio exercise or strength training better for reducing heart disease?

Now, don’t get me wrong. Cardio training is still king because those who do regular cardio exercise have a 32% lower risk. The point, however, is that for those who regularly performed both cardio and resistance training, the risk of death was reduced by a solid 41% compared to sedentary subjects.

The benefits of cardio exercise are well known, but it’s less clear why resistance training helps reduce the risk of death from all causes, especially from heart disease. Jessica Gorzelitz, lead author of the study, thinks that resistance training improves overall health and heart health due to the increase in health-promoting muscle mass and reduction in body fat, which in turn does great harm to health. Gorzelitz also thinks that the unique demands on blood flow with resistance training can promote cardiovascular adaptations that are beneficial throughout the body.

As a result, you should include both cardio and resistance training for maximum benefits, especially when it comes to the effect of exercise to reduce the risk of death from heart disease.

Reach Bryant Stamford, professor of kinesiology and integrative physiology at Hanover College, at [email protected].

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