Good morning! We received a request after the last newsletter to discuss Coronary Calcium Scores. To be clear, these are my thoughts and do not necessarily represent our other leaders. However, if they agree, that’d be really cool.

Coronary Calcium Scores: A Simple Test That Can Save Lives

One of the most common questions I get is: “How do I really know what’s going on with my heart?” You might feel fine. You might exercise. Your cholesterol numbers might even look okay. Yet heart disease can quietly develop for years before any symptoms appear.

That’s where the coronary calcium score comes in.

What is a coronary calcium score?

It’s a quick, noninvasive CT scan that looks for calcium deposits in the arteries that supply blood to your heart. Calcium is a marker of plaque, and plaque buildup is what leads to heart attacks. Think of this test as a way to peek inside the pipes before a major clog causes trouble.

The scan takes just a few minutes, involves no needles or dye, and requires no special preparation. It measures the amount of calcified plaque in your coronary arteries and gives you a score:

• 0 – No detectable plaque. Excellent news.
• 1–99 – Mild plaque. Early signs of coronary disease.
• 100–399 – Moderate plaque. Higher risk.
• 400+ – Extensive plaque. Significantly elevated risk.

Higher scores mean more plaque and a higher risk for heart attack and stroke.

Who should consider getting one?

This test is most useful for people who are at intermediate risk for heart disease, especially adults between ages 40 and 75 who don’t have symptoms but may have risk factors such as:

• Family history of early heart disease
• High cholesterol or blood pressure
• Diabetes
• Smoking history
• Being overweight

It’s particularly helpful when you’re “on the fence” about starting medications like statins. A calcium score can help clarify your personal risk and guide smart decisions.

Why is this test so powerful?

Traditional risk calculators estimate your risk based on population averages. A coronary calcium score shows your personal artery health. That is, what’s actually happening inside your body.

A score of zero is incredibly reassuring. Research shows that people with a zero score have extremely low rates of heart attacks, less than 1% per year, for at least 10 to 15 years. This often allows people to safely avoid medication, focusing instead on lifestyle.

On the other hand, a high score can be a powerful wake-up call. I’ve seen many patients say, “This was the moment I finally took my health seriously.”

What if my score is high?

First, don’t panic. A high score doesn’t mean a heart attack is imminent. It means we now have important information and time to act.

Treatment usually focuses on:

• Improving nutrition

• Increasing physical activity

• Managing blood pressure and cholesterol

• Sometimes starting medications like statins

• Prioritizing sleep and stress reduction

This is where daily movement, especially walking, becomes a game-changer.

Where walking fits in

Regular walking improves blood pressure, blood sugar, cholesterol, inflammation, stress levels, sleep, and overall cardiovascular fitness. Few interventions are safer, cheaper, and more effective.

Even 30 minutes most days of the week can significantly reduce heart attack risk, regardless of your calcium score. And walking with others makes it easier, more joyful, and more sustainable.

Should everyone get this test?

Not necessarily. If you’re very low risk or already known to have heart disease, the test may not change your treatment plan. But for many adults in the middle, those with some risk factors but uncertainty about next steps, it provides valuable clarity and peace of mind.

If you’re curious, talk with your healthcare provider about whether a coronary calcium score makes sense for you.

The bottom line

Heart disease often develops silently, but it doesn’t have to catch us by surprise. A coronary calcium score can shine a light on what’s happening inside our arteries and help guide smarter prevention.

And no matter your score, one of the best prescriptions remains beautifully simple:

Keep Walking. Together

David