Coronary artery calcium (CAC) measures calcification in the coronary arteries, the heart’s blood vessels. This calcification often indicates atherosclerosis, a condition where plaque builds up inside the arteries. A coronary calcium score provides insights into heart health and potential for future cardiovascular events.
Understanding Coronary Artery Calcium Scores
A coronary artery calcium score directly measures calcified plaque in the heart’s arteries, acting as an early indicator of atherosclerosis. This score is obtained through a CT scan of the heart, which reveals calcium deposits within the coronary arteries.
The results are typically reported as an Agatston score, quantifying the amount of calcified plaque based on its area and density. A score of zero indicates no visible calcium, suggesting a low risk of developing a heart attack. Higher scores, ranging from zero to several hundred or more, indicate a greater burden of calcified plaque and an increased risk of cardiovascular events like heart attacks and strokes, potentially for up to 15 years.
The score provides a more precise assessment of an individual’s risk for future cardiovascular events than traditional risk factors alone. It can reveal early-stage atherosclerosis even in individuals without symptoms. The test is often recommended for individuals with intermediate risk factors, such as high blood pressure, high cholesterol, diabetes, or obesity, to help guide treatment and medication decisions.
Can Calcium Scores Be Reversed?
Established calcium deposits within the coronary arteries are generally not reversible. This is because calcified plaque forms a stable, hardened structure within the artery walls.
Even though the calcium score itself may not decrease, the progression of calcification can often be slowed or halted. This distinction is important for managing expectations, as the goal shifts from dissolving existing calcium to preventing further accumulation and reducing overall cardiovascular risk. Lifestyle modifications and medical management play a significant role in achieving this stability.
While the calcium score itself may not decrease, some high-intensity statin therapy might reduce plaque buildup. However, the primary focus remains on preventing further progression and stabilizing existing plaque to minimize the risk of complications like plaque rupture, which can lead to heart attacks.
Strategies for Managing Calcium Buildup
Managing calcium buildup focuses on preventing its further progression and reducing overall cardiovascular risk. This involves a combination of lifestyle modifications and, when necessary, medical management.
Lifestyle Modifications
Adopting a heart-healthy diet is a fundamental strategy, emphasizing foods low in saturated fats, cholesterol, and sodium. Diets like the Mediterranean or DASH plan, which prioritize fruits, vegetables, whole grains, lean proteins, and healthy fats, are often recommended.
Regular physical activity is another impactful lifestyle change. Engaging in at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, cycling, or swimming, can significantly improve heart health. Exercise helps lower blood pressure, improve cholesterol levels, promote weight loss, and enhance heart efficiency, all contributing to slower plaque progression. Maintaining a healthy weight further reduces the burden on the cardiovascular system.
Quitting smoking is one of the most impactful steps to prevent further calcification and reduce cardiovascular risk. Smoking directly contributes to arterial damage and calcification; cessation can lead to reduced arterial stiffness and a lower risk of heart events. Stress management techniques, like yoga or meditation, can also support heart health by reducing blood pressure and overall cardiovascular strain.
Medical Management
Medical management often complements lifestyle changes, especially for individuals with significant risk factors or existing calcification. Medications to control underlying conditions like high cholesterol, high blood pressure, and diabetes are frequently prescribed. Statins, for instance, are commonly used to lower “bad” LDL cholesterol and can help stabilize plaque and reduce inflammation in the arteries. Other medications, such as ACE inhibitors or ARBs for blood pressure control and low-dose aspirin to prevent blood clots, may also be part of a comprehensive treatment plan tailored by a healthcare provider.
Interpreting Your Calcium Score and Next Steps
Interpreting your coronary artery calcium score involves understanding general risk categories, but it is crucial to discuss the results with a healthcare professional for a personalized assessment. A score of zero indicates no detectable calcified plaque and is associated with a very low risk of a heart attack in the near term, typically less than 1% over 10 years. This score suggests a low likelihood of obstructive coronary artery disease.
Scores between 1 and 99 signify a small amount of plaque and a low to mild risk, indicating that the atherosclerotic process has begun. A score ranging from 100 to 399 suggests moderate plaque deposits and is associated with a moderate to relatively high risk of a heart attack within the next three to five years. Scores of 400 or greater indicate a significant plaque burden and a high risk of future cardiac events.
Your doctor will combine the calcium score with other individual risk factors, such as age, family history of heart disease, blood pressure, and cholesterol levels, to form a complete cardiovascular risk assessment. This comprehensive evaluation helps determine the most appropriate prevention and management plan tailored to your specific needs. Regular follow-up with a healthcare professional is important to monitor your heart health and adjust strategies as needed.