By John A. Rumberger, PhD, MD, FACC
Director of Cardiac Imaging
The Princeton Longevity Center
The answer is Yes and NO, but it depends on a number of factors. Atherosclerosis or “hardening of the arteries” occurs when certain substances build up in your artery walls including cholesterol, calcium, blood cells, and muscle cells. The causes of plaque build-up include age, sex, genetics, environment, lifestyle, smoking, cholesterol levels, high blood pressure, obesity, and diabetes. For reasons not totally clear, these factors combine to cause a major inflammatory reaction in the artery wall which brings in more cholesterol, calcium, and blood/muscle cells, actually setting up repeated episodes of inflammation that can “percolate” years before any heart or vascular symptoms.
Your goal is to stop additional plaque build up and/or significantly slow down the ‘natural progression’ of plaque as we all age. It is unlikely that it will ‘all go away’ but possibly some of it can be removed over time.
The best way to lower your heart/vascular risk is to retard or stop the growth of further inflammation and plaque build-up in the walls of the arteries. Studies using the HeartScan [64-slice CT as we use at PLC] have shown that people who slow down or even stop calcified plaque progression cut their risk of a heart attach by 50%!
There are many things for you and your physician to help slow down plaque progression. These include working on altering the risk factors that we can control. Such as: quitting smoking, having a proper diet low in carbohydrates and high in lean sources of protein with goals for achieving an ideal body weight/composition, adequate and frequent exercise, proper vitamins/antioxidants, daily aspirin, control/lowering of cholesterol and use of the proper prescription cholesterol lowering medications to reach new goals, treatment of diabetes and control of blood sugar and blood pressure. Since you now have a baseline coronary calcium score you have the ability to repeat the scan at a later date to measure whether your plaque has stabilized or even regressed.
Your first repeat HeartScan should be in one to three years, depending on the baseline coronary calcium score and location of plaque. It is very important that you work with your doctor to stabilize plaque disease. Calcium score progression [i.e. additional plaque build-up] at or below about 15% per year indicates that your prevention program is “right on target”. Plaque build-up at between 15% and 30% per year indicates that your prevention program is having some success, but needs to be re-evaluated by you and your doctor to see if further steps can be taken to improve your program. Plaque build up at more than about 40% per year indicates that your prevention program needs to be carefully reviewed and that further steps are needed to slow the disease process.