A coronary artery calcium (CAC) score provides insights into an individual’s heart health by measuring calcified plaque in the arteries supplying blood to the heart. This measurement helps assess the risk of future cardiovascular events, as calcium indicates long-term plaque accumulation.
Understanding Calcium Scores
A calcium score quantifies calcified plaque in the coronary arteries, obtained through a non-invasive computed tomography (CT) scan of the heart. This scan detects calcium deposits, which are markers of atherosclerosis. Score ranges indicate different levels of cardiovascular risk:
A score of zero suggests no identifiable calcified plaque and a lower risk of future heart events for the next five to ten years.
Scores between 1 and 100 indicate minimal to mild plaque buildup.
Scores from 101 to 400 suggest moderate calcification and an increased risk.
A score exceeding 400 signifies extensive plaque and a higher risk of heart attack or stroke.
This score reflects accumulated damage rather than active disease.
The Reality of Lowering Calcium Scores
Lowering an existing coronary artery calcium score, meaning reversing formed calcification, is not possible with current medical interventions. Calcified plaque represents a long-standing process of arterial hardening and damage; once formed, deposits tend to remain. Therefore, the focus shifts from reversing existing calcification to preventing further accumulation, aiming to slow or halt progression and reduce cardiovascular event risk.
Strategies for Managing Calcium Score Progression
Managing the progression of coronary artery calcification involves a multifaceted approach, combining lifestyle modifications with medical interventions to address underlying risk factors.
Heart-Healthy Diet
Adopting a heart-healthy diet is foundational to managing calcium score progression. Dietary patterns such as the Mediterranean diet or the DASH (Dietary Approaches to Stop Hypertension) diet emphasize fruits, vegetables, whole grains, lean proteins, and healthy fats. These diets help in controlling blood pressure, cholesterol levels, and blood sugar, all of which influence arterial health. Reducing intake of saturated and trans fats, processed foods, and added sugars can directly impact plaque formation and inflammation in the arteries.
Regular Physical Activity
Regular physical activity also plays a significant role in slowing calcification. Engaging in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week can improve cardiovascular fitness. Activities like brisk walking, jogging, cycling, or swimming help lower blood pressure, improve cholesterol profiles, and promote healthy blood vessel function. Consistent exercise contributes to better overall metabolic health, which helps mitigate risk factors for calcification.
Maintaining a Healthy Body Weight
Maintaining a healthy body weight is another impactful strategy. Excess weight, particularly around the abdomen, is linked to higher blood pressure, unfavorable cholesterol levels, and increased risk of diabetes. Losing even a modest amount of weight can improve these markers, thereby reducing the burden on the cardiovascular system. Achieving and sustaining a healthy weight can significantly contribute to slowing the progression of arterial calcification.
Smoking Cessation
Smoking cessation is important for individuals with any level of calcification. Smoking severely damages the lining of blood vessels, accelerating plaque buildup and calcification. Quitting smoking immediately reduces inflammation and improves endothelial function, which can slow the progression of arterial disease.
Stress Management and Sleep
Effective stress management techniques and adequate sleep also support cardiovascular health. Chronic stress can elevate blood pressure and inflammation, contributing to arterial damage. Practicing mindfulness, meditation, or engaging in hobbies can help mitigate these effects. Aiming for 7-9 hours of quality sleep per night supports the body’s repair processes and helps regulate hormones that influence heart health.
Medical Management
Beyond lifestyle, medical management of underlying risk factors is often necessary.
Blood Pressure Control
Controlling high blood pressure is important. Medications such as ACE inhibitors, ARBs, or calcium channel blockers may be prescribed to maintain blood pressure within healthy ranges, reducing the force on arterial walls. Managing blood pressure helps prevent further damage to the arteries.
Cholesterol Management
Addressing high cholesterol levels, particularly elevated LDL (“bad”) cholesterol, is important. Statin therapy is commonly used to lower LDL cholesterol, stabilize existing plaque, and reduce inflammation. These medications work by inhibiting cholesterol production in the liver and can significantly reduce the risk of cardiovascular events. Statins have been shown to slow the progression of coronary calcification in some studies.
Diabetes Management
For individuals with diabetes, strict blood sugar control is vital. High blood sugar levels can damage blood vessels over time, accelerating atherosclerosis and calcification. Medications like metformin, SGLT2 inhibitors, or GLP-1 receptor agonists, along with dietary and lifestyle adjustments, help maintain stable glucose levels. Comprehensive management of diabetes is a direct measure to protect arterial health and slow calcification progression.
When to Consult a Doctor
A calcium score provides valuable information, but it represents only one piece of a comprehensive cardiovascular risk assessment. It is always advisable to discuss your specific calcium score and individual risk factors with a healthcare provider. A doctor can interpret the score within the context of your overall health profile, family history, and other medical conditions. They can then help develop a personalized management plan tailored to your needs.