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Just how old are your arteries?

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  • Just how old are your arteries?

    Here is a simple way to find out the approximate age of your arteries compared to your chronological age. You need to know your Coronary Calcium Score, Blood Pressure and Cholesterol Levels.


    Overview


    Arterial age provides a convenient transformation of coronary artery calcium (CAC) from Agatston units to age units, to a scale more easily appreciated by both patients and treating physicians. The arterial age for a participant is the age at which the estimated CHD risk (modeled as a function of age) is the same as that for the observed CAC score. Arterial age is then the risk-equivalent of coronary artery calcium. This measure can be considered a more easily understandable version of the CAC score (e.g. you are 55 years old, but your arteries are more consistent with an arterial age of 65 years).

    This tool will calculate an estimated arterial age (and 95% confidence interval) given a CAC score input by the user. Optionally, one can also provide the observed age, gender, total cholesterol, HDL cholesterol, smoking status, systolic blood pressure and use of anti-hypertensive medications and obtain two versions of estimated 10-year CHD risk based on the Framingham (NCEP) point based equations: one using original age, and the other using estimated arterial age. This does not apply to diabetics.

    Robyn L. McClelland, PhD, Khurram Nasir, MD, MPH, Matthew Budoff, MD, Roger S. Blumenthal, MD, and Richard A. Kronmal, PhD.
    Arterial Age as a Function of Coronary Artery Calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA]), Am J Cardiol. 2009 January 1; 103(1): 59–63


    To use Arterial Age Calculator please click the button below: Click image for larger version  Name:	Screen Shot 2017-12-07 at 10.29.42 AM.png Views:	1 Size:	95.2 KB ID:	39

  • #2
    CIMT gives an estimate of arterial age as well. It uses mathematical averaging the plaque thickness in the carotid artery. The CAFE de CAVES study was a landmark in this area. It documented the unrecognized risk of heart attack and stroke when there are significant plaque findings on the CIMT.

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    • #3
      Here are a couple of Youtubes on CIMT.
      https://www.youtube.com/watch?v=QOWF0KTNu2g&t=6s
      https://www.youtube.com/watch?v=xfC4EN2I6SE

      This is a Youtube Playlist on CIMT and arterial age. https://www.youtube.com/watch?v=QOWF...p9WedG7bJ0uy0k

      Comment


      • #4
        Yes, indeed CIMT shows real life imaging. Unlike Coronary Calcium Scoring which only shows a volume of hard calcified plaque in our arteries, CIMT also shows the more unstable and vulnerable soft plaque which is far more likely to cause heart attacks and strokes. CIMT shows real-time risk whereas CAC scores show what happened months and years ago.

        Here is a video on the CIMT test:

         

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        • #5
          And, no radiation from CIMT vs CAC.

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          • #6
            Correct. No radiation.

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            • #7
              Blood vessel age gives a helpful change of coronary corridor calcium CAC from agatston units to age units, to a scale all the more effortlessly valued by the two patients and treating doctors, the blood vessel age for a member is the age at which the assessed CHD hazard displayed as a component of age is equivalent to that for the watched CAC score

























              My life is my message
              http://advancedhairstudio-vic.com.au/

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              • #8
                There are some distinctions in this area. Arterial age is one of 2 main indicators on a CIMT. The other is Mean Max ( of the average of the peaks of plaque). Coronary Calcium scores don't really break down into arterial age so much as showing calcium. And calcium appears to be an indicator of overall plaque history/growth.

                Comment


                • #9
                  Click image for larger version

Name:	CIMT.JPG
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ID:	2988

                  Just out of curiosity I calculated my arterial age using the MESA calculator linked above. It says based on my actual age (54) and CAC (0) that my arterial age is 39.

                  My CIMT result shows an arterial age of 22 (average CCA mean IMT of 0.49). The average CCA max regions on the CIMT are 0.57, which is far above the mean - so not so great. Unfortunately, I was shocked to find out that my CIMT showed that those supposedly 22 year old arteries have a 1.3 mm echogenic plaque. If the reading on that section were 1.2 mm instead of 1.3, it seems that the report would have been all green and I might not have investigated further. From what I have now read, any measurement above 1 mm on a CIMT would be considered abnormal even if it isn't considered a "plaque" per se. My understanding is that there is also a margin of error in the readings taken by the ultrasound so the thickness could be higher or lower than that reported. Nevertheless, an echogenic reading means I definitely have plaque.

                  What value is there to the arterial age calculation if there is plaque present? How concerned should I be with those results?
                  Last edited by Sapien; 11-02-2019, 02:52 PM.

                  Comment


                  • Tom
                    Tom commented
                    Editing a comment
                    By chance, were you taking a statin for the previous few years before your CIMT result? If so, then your results make sense in that a statin/change in lifestyle can more easily remove the soft plaque in your arteries resulting in a lower arterial age. The plaque that has been around a while and is either calcified or becoming calcified doesn't get removed as easily. Was your CAC score and CIMT test done close together in time or was there a several year gap?

                  • Sapien
                    Sapien commented
                    Editing a comment
                    The CAC was in 10/2018 and the CIMT in 09/2019. I started taking atorvastatin 10 mg in 02/2019. My understanding is that statins can have the effect of calcifying and stabilizing plaque. I was wondering if that plaque that was identified (1.3mm echogenic) might have actually been calcified by the statin (or possibly by increasing my vitamin D levels).

                    The measurements at both bulbs were also much higher than the average IMT but were not identified as plaque. I wonder if those areas were also calcified but not identified as any type of plaque on the report since the measurement was below the 1.3 mm.

                    Since this was my first CIMT, I don't know what the average IMT was before starting the statin. What is the largest reduction in IMT that someone has seen in less than a year simply because of using a statin? Might increasing vitamin D also reduce IMT?

                    Would it make any sense to repeat the CAC this year to see if the statin has had the effect of calcifying any soft plaque that might have been in the coronary arteries but isn't detected by CAC?

                  • Tom
                    Tom commented
                    Editing a comment
                    Yes, the statin you were taking might have accelerated the calcifying and stabilization of the discrete plaque. It would likely be even better if you were on rosuvastatin vs. atorvastatin as rosuvastatin is better at reducing cardiovascular inflammation. Do a search on Dr. Brewer's YouTube videos about the benefits of rosuvastatin (and ramipril if you are on an ARB for hypertension). I recently saw an interesting article on how natural calcification of plaque is at a micro level while adding a statin will increase that calcification/stabilization at a macro level. I will post that article in a new topic soon as I think that it is important. I don't personally follow many peoples' soft plaque reversals, but Dr. Brewer did several YouTube videos showing that his arterial age went down something like 20 years after being on a statin for a year or a little longer. Again search for those videos and have a good look. Personally I would wait for five years to get a repeat CIMT test done, but that is only because I cleaned up my diet, exercise and sleep routines.

                    As to whether vitamin D had some effect on reducing your IMT, perhaps is the best guess I can make. It can be very difficult to tease out specific cause and effect when people make multiple lifestyle changes in a relatively short period of time. Once you have been on a statin for a while, I am not sure what real knowledge that you will gain by having another CAC score taken. How much of the CAC score increase is due to calcification of old plaque and how much of calcification of any new plaque with the statin driving the calcification/stabilization at a much high rate? A CIMT test will give you a much better understanding. Your really best bet is to do a careful evaluation of your diet, exercise, sleep and stress patterns; and optimize those to the extent possible. Do you really need to test, test, test? In my opinion no, fix what is broken. Are you overweight, smoke, have sleep apnea, don't do vigorous exercise, etc. (the list goes on and on)?
                    Last edited by Tom; 11-06-2019, 05:49 AM.

                • #10
                  There are 2 variables that have been shown to indicate risk: the IMT ( arterial age) and the discreet plaque burden & consistency. There is not total agreement in yours. There's no question it's a mixed message. However, you are correct; you do appear to have increased risk. This is not common, but I've seen it before. I'd recommend acting on the risk and watching the progression.

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