CALCULATING CALCIUM

This test can see a heart attack in your future

- PAULA SPAN

A long list of Lynda Hollander's paternal relatives had heart disease, and several had undergone major surgeries. So when she hit her mid-50s and saw her cholesterol levels creeping up after menopause, she said: "I didn't want to take a chance."

A cardiologist told Hollander that based on factors like age, sex, cholesterol and blood pressure, she faced a moderate risk of a major cardiac event, like a heart attack, within the next 10 years.

Doctors typically counsel such patients about the importance of diet and exercise, but Hollander, now 64, a US social worker in West Orange, New Jersey, didn't have much room for improvement. She was already a serious runner, and although "I fall off the wagon once in a while" her diet was basically healthy. Attempts to lose weight didn't lower her cholesterol.

Her doctor explained that a coronary artery calcium test, something Hollander had never heard of, could provide a more precise estimate of her risk of atherosclerotic heart disease. A brief and painless CT scan, it would show whether the fatty deposits called plaque were developing in the arteries leading to her heart.

When plaque ruptures, it can cause clots that block blood flow and trigger heart attacks. The scan would help determine whether Hollander would benefit from taking a statin, which could reduce plaque and prevent more from forming.

"The test is used by more people every year," said Dr Michael Blaha, co-director of the preventive cardiology programme at Johns Hopkins University. Calcium scans quadrupled between 2006 and 2017, his research team reported, and Google searches for related terms have risen even more sharply.

Yet "it's still being underused compared to its value," he said.