Fish oil and heart health with high heart scan (CAC) score of 850

[T4 Life]

Is prescription fish oil containing EPA/DHA really that bad? I had a heart scan (CAC) and came back high at 850. Doc wants me on Lisinopril and Atorvastatin my latest blood work shows Total Cholesterol 213, Triglycerides 98, LDL 157, HDL 35, glucose 90. I weigh 184 lbs. 5'10 at 57 years old. My blood pressure average is 137/85 but at the Doc office it's usually higher 170/90-100 so I guess that helped the doc justify the need for meds but I am reluctant to start but I am considering taking fish oil at 2 grams twice a day morning and evening in an attempt to avoid having a cardiac event. I have an appointment with a cardiologist but that over is a month away. Any experience or advise with these matters is greatly appreciated. Thank you.

 

[Guided_by_Voices]

From everything I've read and heard, there is no downside to fish oil and lots of upside. There is a company called OmegaQuant that has inexpensive test kits to check you Omega 3 levels. That said, Omega 6 apparently "competes" with Omega 3 so one of the best ways to increase the actual uptake of Omega 3 is to eliminate vegetable oils which will drop omega 6 intake. More importantly, here is a list to start with...

20 Heart-Healthy Actions With Better Risk/Reward Than Statins

Here at Excelmale there are frequent posts discussing the pros and cons of statins, and one in particular several weeks ago where a position paper was cited where the assumption was that statins are not only a viable option but should be the first line of defense against heart disease. As I have...

www.excelmale.com

 

[Vince]

Studies on fish oil

CME: Omega-3 Fatty Acids in the Management of Hypertriglyceridemia: New Findings and Formulations - Continuing Medical Education (CME):Princeton Media Associates, exp. 10/29/06 - "To lower TG levels, the dose of omega-3 therapy is ~4 g of EPA + DHA per day" Omega-3 Fatty Acids: Recommendations...

www.excelmale.com

 

[DorianGray]

I take 2000mg fish oil daily with table spoon of EV,high polyphenol olive oil daily. Many years of doing this. My labs from 6/21:

Cholesterol total 166mg/dL
HDL 66
Triglycerides 75
LDL 84
chol/hdlc ratio 2.5
Non HDL cholesterol 100

However, I think there is a strong genetic component to how the body deals with fats, fatty acids.

 

[Dicky]

From everything I've read and heard, there is no downside to fish oil and lots of upside. There is a company called OmegaQuant that has inexpensive test kits to check you Omega 3 levels. That said, Omega 6 apparently "competes" with Omega 3 so one of the best ways to increase the actual uptake of Omega 3 is to eliminate vegetable oils which will drop omega 6 intake. More importantly, here is a list to start with...

20 Heart-Healthy Actions With Better Risk/Reward Than Statins

Here at Excelmale there are frequent posts discussing the pros and cons of statins, and one in particular several weeks ago where a position paper was cited where the assumption was that statins are not only a viable option but should be the first line of defense against heart disease. As I have...

www.excelmale.com

Yes. Vegetable oils are not your friend.

 

[Golfboy307]

Fish Oil is not a replacement for primary drugs that help combat heart disease. They normally combat high triglycerides, which you don't really have. As the posters mention, there aren't many downsides, so I am sure that will be part of your plan. With an 850 calcium score, you have some serious plaque. When you meet with your cardiologist, I would ask him about underlying causes such as inflammation, your diabetic profile and if you have high LP(a). Obviously treating your BP will be a primary consideration. Cholesterol is only a small piece of the puzzle. A good friend of mine had a 750 score and ended up with two stents shortly thereafter. It is something you should definitely take seriously. Best wishes to you! Make sure to ask a lot of questions.

 

[Guided_by_Voices]

Another issue with the CAC scores is that they don't tell you when the calcification was predominantly caused unless you've had multiple scans. There are some high-profile athletes that ended up with meaningful plaque likely due to the stress of their sports and which could have been provoked in the distant past, so it is far from a perfect measure. I would also read Dr. Malcolm Kendrick's (lengthy) series on What Causes Heart Disease and especially his post on the issues with the CAC scan. At a minimum his series will acquaint you with many of the topics involved in heart disease.

 

[UCFguy01]

A lot of people have lowered their CAC score by eating a low carb high fat diet. Ivor Cummins is one of the guys who promotes heart health through the LCHF diet. He talks about how high carb diets are causing diabetes and heart disease and how they're both linked. He also suggests that everyone get a CAC score to see where they're at. I got one done last year. Thankfully it was a zero score. Are you diabetic at all? Have you checked your A1C?

 

[T4 Life]

A lot of people have lowered their CAC score by eating a low carb high fat diet. Ivor Cummins is one of the guys who promotes heart health through the LCHF diet. He talks about how high carb diets are causing diabetes and heart disease and how they're both linked. He also suggests that everyone get a CAC score to see where they're at. I got one done last year. Thankfully it was a zero score. Are you diabetic at all? Have you checked your A1C?

No I don't consider myself a diabetic I don't take insulin or metformin neither have I been diagnosed as one yet.
My A1C
09/2017 5.6
11/2019 5.6
6/2020 5.7
12/20 5.7

I'm reducing my carb intake substantially and increasing more healthy fats. I had a full cardiac workup in 2017 it was pretty thorough and I received no alarming news and haven't been back since. I recently signed up with a primary doc as I had none for years always went to urgent care in needed so asked for this test CAC and thought it would be denied as usual and to my surprise it wasn't and then I scored to high what a bummer.

Only two visits with this doc and already prescribed statins and blood pressure meds mind you I had no symptoms. bp today 136/80 after 50 min bike ride no meds taken yet no chest pain no shortness of breath but I still worry now more that ever.

 

[Neil]

No I don't consider myself a diabetic I don't take insulin or metformin neither have I been diagnosed as one yet.
My A1C
09/2017 5.6
11/2019 5.6
6/2020 5.7
12/20 5.7

I'm reducing my carb intake substantially and increasing more healthy fats. I had a full cardiac workup in 2017 it was pretty thorough and I received no alarming news and haven't been back since. I recently signed up with a primary doc as I had none for years always went to urgent care in needed so asked for this test CAC and thought it would be denied as usual and to my surprise it wasn't and then I scored to high what a bummer.

Only two visits with this doc and already prescribed statins and blood pressure meds mind you I had no symptoms. bp today 136/80 after 50 min bike ride no meds taken yet no chest pain no shortness of breath but I still worry now more that ever.

Well, officially you are prediabetic. Don't feel bad, I had you beat at 5.8, my wife was 6.2 and symptomatic. I'm lower now since I lost 45lbs on Keto (and counting, I'm still on Keto). If I were you, I would buy a finger stick blood glucose meter and check your 1.5 hours after eating glucose. The fasting glucose you state up above means little unless overt diabetes is suspected.

 

[Guided_by_Voices]

Note that blood sugar must be evaluated in the context of insulin. If blood sugar is low but high insulin is keeping it that way (per the famous Kraft diagram) that is still really bad.

 

[Neil]

Note that blood sugar must be evaluated in the context of insulin. If blood sugar is low but high insulin is keeping it that way (per the famous Kraft diagram) that is still really bad.

Absolutely true! A really proper workup would evaluate fasting and general overall insulin as well. Blood glucose (fasting) can indicate fairly normal for many years...all the while fasting insulin and general blood insulin levels could have been rising- this is true insulin resistance (but never known because most doctors do not test for this- insurance companies don't want to pay for this without a diagnosis code- and patients throw a huge fit when a good doctor checks a lot of boxes on the lab sheet because they get a big bill). Then one day Jim Bob's pancreas just flat gives up and can't deal trying to pump out all that big insulin and throws in the towel....and we have full-blown insulin injecting diabetes and downward health spiral. I know two people this exact thing happened to. Having a finger stick blood glucose tester on hand to measure postprandial glucose one hour after eating can offer a clue... but insulin levels are also critical to one's future. Here is one man's crazy story

 

[DragonBits]

What is your history of blood pressure results, has your BP been above 120 for years or is this sudden?

From what you have posted, it seems likely you have some level of coronary artery disease.

You could get additional vascular reactivity / vascular function tests, this usually involves ultrasound and measuring blood flow changes.

If your BP is unusual and not typical of past results, then perhaps something like magnesium, calcium or other supplements would lower BP.

I would also test for HS C-reactive protein as an indication of inflammation.

I take fish oil but have NO faith it helps, from what I have read there is good evidence it can lower triglycerides but very mixed and inconclusive evidence it helps prevent heart problems. As opposed to eating fish often.

I agree that fish oil is pretty safe.

 

[T4 Life]

What is your history of blood pressure results, has your BP been above 120 for years or is this sudden?

From what you have posted, it seems likely you have some level of coronary artery disease.

You could get additional vascular reactivity / vascular function tests, this usually involves ultrasound and measuring blood flow changes.

If your BP is unusual and not typical of past results, then perhaps something like magnesium, calcium or other supplements would lower BP.

I would also test for HS C-reactive protein as an indication of inflammation.

I take fish oil but have NO faith it helps, from what I have read there is good evidence it can lower triglycerides but very mixed and inconclusive evidence it helps prevent heart problems. As opposed to eating fish often.

I agree that fish oil is pretty safe.

My blood pressure hovers around 134/88 for me this is normal if it gets any higher I know something is going on however when I go to donate blood or any doctors offices my pressure goes up around 170/100 easily. (anything over 180/100+ I go to ER been there twice they test find nothing.)

As for coronary heart disease I had an pretty extensive work up by a cardiologist back in 2017 nuclear stress test on treadmill w/isotope echocardiogram EKG etc. the results was that there was not heart disease and no obstructions that could be identified unless they were more than 70% I was told. Back then I knew nothing of CAC testing and it was not offered. Fast forward to 2021 and CAC score is 850 and I have been found to have extensive coronary artery atherosclerotic plaque burden with stenosis greater than 50% diameter in at least one region as per the report. (I requested CAC testing not my Doc so I found what they could not)

This is why I asked about fish oil I don't want to take statins or antihypertensive drugs I was thinking fish oil (prescribed) could keep my blood flowing easily and without clotting thus reducing my chances of a coronary event but I'm not so sure I'm still hesitant to take even fish oil. Yes I don't like taking any pills especially rx.

I'm taking Magnesium chloride, D3 and cutting the carbs and sugars and my blood pressure has already improved my last 3 day average is 133/78. I would never take calcium on its own (as you recommended) especially in my situation.

I have an appt. with cardiologists in Nov. maybe I should ask for your recommendations and see what they say and hope they don't take it the wrong way. Thanks.

 

[DragonBits]

I agree that I wouldn't take calcium supplements, I should have been more specific. I have read some pretty negative information about calcium supplements.

My blood level of calcium is always in the middle of the range, which led me to think it's not a problem. What made me try to increase my intake of calcium rich foods was that I still occasionally get a muscle cramp. (diaphragm or right below my rib cage)

I do take progesterone and magnesium, which also has some sort of influence on CA/MG ratios, though I am not clear exactly how. I take the MG for muscle cramps and to alleviate constipation, and progesterone to help with sleep. It's possible that progesterone / mg had an effect on calcium (cellular/brain, who knows), though nothing ever showed up in blood work.

HOWEVER, drinking 1-2 glasses of milk a day lowered my BP by roughly 15-20 points, which was totally unexpected.

BTW, recently (before consuming more milk) I fell (freak bicycle accident) and hit my head on the concrete. My BP measured by the fire department was 189/??, and later in the hospital it was 169/>??. Shockingly high to me. I am perfectly OK, but there was a really big goose egg on my head, so decided to get checked out just to be safe.