Your Good Health: High blood calcium might not correlate with coronary disease

Dear Dr. Roach: I am a 62-year-old white male who is 5 feet, 11 inches tall and weighs 205 pounds. I have diabetes, high blood pressure and high cholesterol. I was recently diagnosed with “moderate to significant coronary disease” by a CT coronary calcium scan. This was based on a finding of “severe calcification in the coronaries,” as per the radiologist’s cardiac scoring report.

You very likely have a condition called primary hyperparathyroidism , as it is, by far, the most common cause of high blood calcium in healthy people. I am quite surprised, though, that the diagnosis wasn’t made and you weren’t recommended for surgery, since a blood calcium level of more than 1 mg/dL above the upper range of normal is an indication for surgery. Your calcium level is more than 2 mg/dL above this amount.

Coronary artery disease are blockages in the blood vessels that supply blood to the heart. Although a high calcium score makes obstructive coronary artery disease more likely, it is possible to have calcium in the blood vessels without blockages in the coronary arteries. It is true that high calcium in the blood leads to higher coronary calcium scores, but recent studies have shown that surgical treatment of the parathyroid gland tumours that cause PHPT do not reduce the risk of heart disease. So, it shouldn’t be part of your decision to treat PHPT with surgery.

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