Calcium Buildup and Predispostion to Heart Attack

I am a 46 year old male.  About a year ago, the local hospital offered a calcium buildup test for $150.  So I got the test and my reading was 305.  My doctor said it was high for my age and sent me to a Cardiologist.  I went through two different stress tests and everything looked just fine.  
Advance to today which I went back to my Cardiologist for my one-year review.  He was glad that I quit smoking (4 months), and had started a regular exercise program.  Also, he was glad that despite quitting smoking I had lost weight since my last visit.  Through exercise and diet I have managed to lose 10 pounds since last year (although I gained 15 when I quit smoking so really I have lost 25).  
However, he stated that he considered me a high risk for a heart attack.  He said that my chances of having a heart attack in the next 10 year were 20% because of my calcium readings, my parents history (my Dad had 3 heart attacks and the 3rd one killed him at 69 and my Mom had two heart attacks but lived until 80 and died of pneumonia).  He said if I could stay quit from smoking for two years that I would cut that chance to 10% and if I got down to my ideal weight and stayed on a regular exercise program of 45 minutes a day at a heart rate of 125 that I would cut it in half again to 5%.
So, with all that said, I guess I would like a 2nd opinion as to the accuracy of his thoughts.  Do you agree that I am at a 20% chance of having a heart attack in the next 10 years or is that high?  Can I really cut my chances of having an attack by the percentages he said by doing the things that he said?  Finally, he said that my calcium reading could never be reversed... that no matter what I did I would always be at least 300 and that would go up.  Do you consider 305 to be that hight for 46 and is it true it can only go up but never go down?  Thank you!

[Lee Kirksey, MD]

Hello
Lots of questions. First congratulations on improving your health through life style changes. It sounds like the calcium score was he jolt that you needed

The role of calcium scoring is controversial (see my blog). Calcium is one indicator of the potential for the development of cholesterol blockages along with your other risk factors like cholesterol, hypertension, smoking, family history and activity to name a few.

The fact that you have a significant family history is probably your largest risk factor. Did your mom and dad smoke, have high cholesterol, overweight?

You said how much weight you lost, but not how much you still weigh? What is your total cholesterol LDL, HDL

I think that your cardiologist was trying to give you some general risk estimates for having a heart attack with his main point being that if you quit smoking, continue to exercise and live healthy your risk of having a heart attack is significantly less than if you dont do these things. I agree with him and Im sure you do as well

The calcium changes that you have developed are permanent and will not regress. That is old damage from your years of smoking and high cholesterol. It is impossible for me to compare your calcium score because the grading system varies from testing facility to testing facility and the number is relative based upon each facility's scale.

If I were you, I would focus less on the absolute number and use it as evidence that you have vessel changes. You know given your parents history that you are at risk. Your cholesterol and blood pressure should be optimized to and LDL <100. Your goal should be to optimize your health and to continue the current changes that you have made. good luck

[concerned2008581]

Thank you Dr. Kirksey.  Yes, I am overweight by 50 lbs. but working on it.  Both of my parents smoked but were not overweight.  They both had high BP and high cholestoral.  I just took another blood test and will let you know what my cholestoral readings are... but I can tell you my bad cholestoral is about 150 because they took me off my Liptor (liptor) temporarily because my liver readings were high and my cholestoral didn't go up much... I think to about 160.  I know they always say my good cholestoral is always high.  
One thing my Dad never would do is face his health issues.  He reluctantly went to the doctor and when he did, he never followed their advice.  I am trying to be proactive, but sometimes I think that keeps me in a constant testing/analysis mode because that's what doctors do.  I think most of my peers my age just float along and may have the same issues but just dont know.   Thanks.

[concerned2008581]

I went to see your blog on calcium buildup and couldn't find it.  Could you direct me please?  Thanks!

[kitcurious]

http://www.medhelp.org/doctor_profiles/show/469720  ;
I hope this link works to the blogs. They are listed on the far right-hand side of the screen. Good luck to you. I admire you for all your hard work.

[Lee Kirksey, MD]

I know that you're on the right path. You're right that our medical system is flawed. Its a fix it when it's broken system that is weighed heavily towards testing and prescribing medications. In your case you have to take the initiative to continue not smoking, get down to ideal weight and adhere to a low cholesterol, low fat diet.

It is an encouraging fact that your dad had bad health do to his habits and not his genes. worst case scenario is when someone says "my dad died of a heart attack at age 55. He was 150lbs, never smoked, was a vegetarian and exercised each day of his life". Thats bad genes. Good luck