Is a calcium score of my heart worth doing?
For people between 40 and 75 years old in a grey zone regarding statins, a calcium score is a well-supported tool for making a well-considered decision about medication together with your doctor.
A calcium score, also known as a CAC score, measures how much calcification is present in the coronary arteries of your heart. Several major guidelines, including those from the United States (ACC/AHA), Europe, Australia, China and Japan, recognise the test as a useful tool for people without known heart disease. The aim is to determine whether you need medication such as statins.
The test is most valuable when it is unclear whether you should start statins. That applies to people between 40 and 75 years old without diabetes, with moderately elevated cholesterol and a ten-year risk of a heart attack of roughly 7.5 to 20 percent. In that grey zone, the score helps to refine that decision, in consultation with your doctor. If your risk is very low or clearly high, the test adds less value.
A score of zero provides extra reassurance: no calcium is visible, and if you do not smoke, do not have diabetes and have no family history of early heart disease, you may, in consultation with your doctor, postpone starting statins. A score of 100 or higher, or above the 75th percentile for your age and sex, makes statin treatment more likely to be appropriate. Not only the quantity of calcium matters: a study of more than 21,000 people showed that more compact, denser calcification is associated with a lower risk than the same amount of less compact calcium. That adds nuance to the picture.
A study of more than 5,700 people without symptoms showed that people with a higher CAC score were more likely to die over twelve years, even after adjustment for other risk factors. That same study made clear that the CAC score sometimes predicts less accurately than the amount of plaque in the carotid arteries. The test is therefore useful, but not the only tool available.
The measurement involves a small radiation dose and costs money; the test is not always reimbursed. Discuss with your general practitioner or cardiologist whether your situation, your age, risk factors and any current medication, genuinely benefits from this additional information, or whether the result would not change your treatment.
All claims are based on guideline documents (ACC/AHA, ESC, and various others) and observational cohort data (BioImage study, meta-analysis of 5 cohorts). There are no randomised trials demonstrating that performing a CAC measurement improves clinical outcomes; its value has been established for risk stratification and decision support.
Are calcium supplements bad for your heart?
Calcium supplements may be associated with an increased heart risk, but not all studies confirm this. It is best to get calcium from your diet, and discuss with your doctor whether a supplement is truly necessary for you.
What does my CRP value (inflammation) say about my heart?
A high hsCRP value points to chronic inflammation and predicts a clearly elevated long-term risk of cardiovascular problems, even more strongly than well-known cholesterol values. It is an independent risk factor that deserves serious attention.
Is high homocysteine bad for my heart?
High homocysteine is associated with a greater risk of cardiovascular disease, but whether it is the cause is not certain. Have your levels checked by your doctor and discuss whether dietary changes or supplementation make sense for you.
How reliable are the heart rate scores from your wearable?
A good wearable measures resting heart rate reliably, but HRV scores and readiness are less accurate than they appear. Use them as a signal over the longer term, not as a hard daily diagnosis.
How much calcium do I need per day, and can too much be harmful?
Calcium requirements range from 800 mg (young children) to 1500 mg per day (older adults, teenagers, postmenopausal women). Up to 2000 mg per day is safe for most people; aim to get calcium from food wherever possible.
Do you really need calcium supplements for strong bones?
Whether you need calcium supplements depends strongly on your age and situation: for healthy women before the menopause there is no evidence of benefit, while women over 50 may benefit from calcium plus vitamin D, provided you weigh the increased risk of kidney stones and the uncertain cardiac risk with your doctor.