Understanding individual risk for heart disease is important. Diagnostic tests provide insights into heart health, guiding proactive measures and helping individuals work with healthcare providers to maintain or improve their heart health.
Understanding the Calcium Score Test
The Coronary Artery Calcium (CAC) score is a specialized imaging test that assesses calcified plaque in the coronary arteries, which supply blood to the heart. It uses a computed tomography (CT) scan to detect and quantify calcium deposits, an early sign of atherosclerosis. This condition involves plaque building up and hardening inside arteries, potentially narrowing them and limiting blood flow.
The CAC test is non-invasive and quick. A CT machine scans the heart, and a program calculates an Agatston score, estimating coronary artery plaque. A score of zero indicates no calcified plaque and a low likelihood of future heart events. Higher scores indicate increasing plaque, with scores over 400 signifying extensive plaque burden and a higher risk of heart attack.
The Role of Percentiles in Medical Results
In a medical context, percentiles compare an individual’s test result to a larger reference population. A percentile indicates the percentage of observations in a dataset that fall below a certain value. For example, a 50th percentile result means half of the reference group had a lower score, helping understand where an individual stands relative to others of the same age and gender.
Percentiles are not percentages; they describe rank within a group. Using percentiles allows healthcare providers to identify if a result is typical, unusually low, or unusually high compared to a relevant population. This comparison is valuable for tests like the calcium score, where raw score significance varies by demographic group, providing a nuanced perspective.
What a 90th Percentile Calcium Score Indicates
A 90th percentile calcium score means an individual has more calcified plaque than 90% of people in their same age and gender group. This suggests a substantially elevated amount of plaque compared to peers. While any calcium score above zero indicates some evidence of coronary artery disease, a 90th percentile result points to a significant burden of atherosclerosis, associated with an increased risk of future cardiovascular events.
Even a moderate raw calcium score can be high in percentile, particularly in younger individuals. A relatively low score in a younger person might still place them in a high percentile because calcium deposits are less common at that age. This emphasizes age-adjusted percentiles for accurate risk assessment. A score in the 90th percentile or higher often indicates a risk comparable to someone with established coronary heart disease, warranting careful attention.
Managing Heart Health After a High Score
Receiving a high calcium score, particularly one in the 90th percentile, often prompts proactive heart health management. The initial step involves consulting a healthcare provider to interpret results within the context of overall health, existing risk factors, and family history, helping formulate a personalized plan.
Lifestyle modifications are a foundational component. Adopting a heart-healthy diet, regular physical activity (at least 150 minutes of moderate activity weekly), and quitting smoking are advised. Managing stress and maintaining a healthy weight also contribute to improved cardiovascular well-being.
Beyond lifestyle changes, healthcare providers may consider medications based on the individual’s risk profile. Statins are often prescribed to lower “bad” LDL cholesterol. Medications to manage high blood pressure or diabetes might also be recommended if present. In some cases, low-dose aspirin may be considered to reduce the risk of blood clots. The goal of these interventions is to stabilize existing plaque, prevent further buildup, and reduce the overall risk of cardiovascular events, even if the calcium score itself may not decrease.