More than 73,000 people die every year from coronary heart disease, the biggest killer in the UK, and although we tend to think of men being more prone, almost as many women are victims. Whatever your gender, you might want to know that there is a simple 10-minute scan that can tell you your risk of having a heart attack.
Standard tests will give a measure of your risk, but you can pass these despite the fact that you may have atherosclerosis, where arteries become clogged with fatty substances called soft plaques, which eventually cause the arteries to harden, narrow and become calcified, restricting blood flow and oxygen. They may also rupture, causing a blood clot to develop. The clot may block the supply of blood to the heart, triggering a heart attack.
The trouble is, these soft plaques are hard to detect. But a CAC (coronary artery calcification) scan, which takes just 10 to 15 minutes, can identify and quantify the more dangerous calcified hard plaques. This scan is then translated into a ‘CAC score’ which can accurately assess your overall ‘disease burden’. The predictive power of the CAC score has been repeatedly demonstrated in studies. These show that you have around an eight times higher chance of a cardiac event simply by having a score above one. If the score is very high, the odds of a heart attack may be 20 to 25 times higher than those of someone with a zero score.
Some people in middle age and beyond have almost no atherosclerosis in their arteries and are significantly more likely to reach a healthy old age than those with extensive atherosclerosis, which increases the risk of heart attack or stroke.
Interestingly, research highlights that people without traditional risk factors – such as increased age, higher blood pressure, poor lifestyle, a family history of heart attacks or high cholesterol – but with elevated CAC scores have much higher rates of cardiac events compared with those who have multiple risk factors but with a CAC score under one.
There are many reasons why there’s such a difference in disease levels between people with relatively clear coronary arteries and those with extensive plaque. It is increasingly recognised that this has less to do with your cholesterol levels and more to do with blood insulin and glucose levels – with diabetes being a major risk factor – along with smoking, being overweight, a sedentary lifestyle and a genetic susceptibility.
So this test will be of particular benefit to those who, having been referred to an NHS cardiologist but deemed at low risk using the traditional screening tool, find that they have a higher than expected risk after a CAC scan. This gives them an opportunity to embrace preventive therapies including diet and lifestyle changes, along with treatment, to reduce their risk of a significant heart attack or stroke. The test is also available privately. For more information, see ihda.ie
Plain food for thought
Many children are conservative in their food tastes. But children with autistic spectrum conditions are more likely to have unusual restricted eating behaviours, which often become a distressing challenge both for them and their parents. New research shows that feeding problems are 15 times more common in autistic children, affecting as many as 70 per cent, according to Susan Mayes, a professor of psychiatry at Penn State University in the US.
Autistic children typically have severely limited food preferences due to hypersensitivity to textures, tastes or temperatures. This makes trying new foods a challenge and they often end up eating only plain food, often of a particular brand or shape. Mayes points out that the earlier autism is diagnosed the sooner parents can access treatment – such as applied behaviour analysis, shown to be most effective in the pre-school years.
According to Mayes, ‘These behaviours are present in many one-year-olds with autism [but not yet diagnosed], and could signal to doctors and parents that a child may be on the spectrum.’
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