How do you know if you have plaque in your arteries?

April 6, 2013 4:01 pm

Why bother checking for plaque?

Because 4 in 10 of us will die from a plaque-related disease – and this is preventable!

What is plaque?

Plaque is the gunk that builds up in your arteries – a bit like rust in pipes. If your arteries (pipes) become blocked everything after the blockage becomes stagnant and dead. This can cause aneurysms, strokes, gangrene and heart attacks.

To ensure your arteries are healthy you want to minimise plaque developing if possible.

How does plaque get in your arteries?

The biggest contributors for plaque building up in your arteries are:

  • Ageing – getting older is the biggest risk factor. That’s why we take particular care assessing this risk as you age
  • Smoking and other lifestyle choices
  • The food you eat – also contributes to plaque buildup. It is wise to limit your intake of foods like cheese, dairy, red meat and those so called “golden foods” (commercially baked pies, pastries and croissants)
  • Eating too many calories – and putting on weight also increases the likelihood of plaque buildup

Your blood pressure and family history – are also key risk factors.

How do you know if you have plaque in your arteries?

Often we look for evidence of plaque using imaging on a case-by-case basis. For example we might suggest a coronary calcium score scan or a CT angiogram scan. “CT” stands for computerised tomography and is sometimes called a CAT scan.

Predicting who may have plaque

A recent study shed light on how difficult it can be to predict who has plaque.

The study’s 5262 patients represented those with NO modifiable risk factors (smoking, hypertension, high cholesterol, or diabetes) in a 12-center prospective cohort of >12,000 patients without known coronary artery disease who were referred for coronary CT angiography.

Referral was made based on symptoms or “clinical concern often due to the presence of a family history of coronary artery disease.”

About 36% of patients were asymptomatic. What was amazing was that only 61% had no coronary artery disease whatsoever. Of those studied with no modifiable risk factors,

  • 12% had narrowing – more than 50% in their coronary arteries
  • 27% had plaque in coronary arteries but less than or equal to 49% narrowing

Don’t forget, these are people that had no modifiable risk factors.

CT scans mean you are no longer guessing

You can identify mild disease and you can also identify significant coronary artery narrowings. Then on that basis you can better understand the downstream prognosis of these patients.” (Dr Jonathon Leipsic – University of British Columbia, Vancouver)

So what happened to these people? Well if you had obstructive coronary disease of more than 50%, your odds as compared to those without obstructive disease of having a heart attack stroke or death was sixfold higher.

Does that mean everyone should have a coronary CT angiogram?

No, I don’t believe so.

At Executive Medicine we think hard about our patients and analyse your personal risk before making recommendations for this test on a case-by-case basis. The biggest contributors to risk are often being over the age of 60 and having a strong family history – that is a first-degree male relative who had a coronary artery disease or stroke diagnosis under the age of 55 (or female under the age of 60). This certainly gets our attention.

We do recognise at our practice that a CT angiogram can be a very useful tool (on a case-by-case basis) to guide treatment.

This test has saved lives in our practice. More frequently, it’s given us important information as to what decisions we need to make to protect arteries.

Written by Dr John Cummins, April 2013

What’s your next step?

Ask us whether you should have a CT angiogram or some other form of imaging with your next annual check up.

To book your next check up