My Coronary Calcium Score is Not Zero: What Are My Next Steps to Improve Heart Health?

You just got your Coronary Artery Calcium (CAC) score back. You held your breath, but the result wasn't the perfect "0" you were hoping for. Maybe it's a "12," a "150," or even higher. It can feel like a punch to the gut. I remember when my uncle got his score back; he was a runner, but his number still came in surprisingly high. The shock was real, but it was also the motivation he needed.

Take a deep breath. Your non-zero score is not an immediate death sentence. It’s a vital piece of information—a crystal-clear map of your internal health. It confirms you have some plaque buildup (atherosclerosis), but the good news is you caught it early enough to change the course of your health. Think of this score as the ultimate wake-up call.

So, your score is not zero. What’s the plan? Here is your step-by-step guide to taking control of your heart health journey.

Step 1: Schedule the Essential Post-Test Conversation

The first and most critical action is to sit down with your doctor or a cardiologist. The raw number is only one part of the puzzle. Your physician will combine your CAC score with your other risk factors (like cholesterol, blood pressure, diabetes, and family history) to create a comprehensive, personalized risk assessment.

• Score of 0 (The "Warranty Period"): This is the ideal result! It generally suggests a very low risk of a heart event for the next 5-7 years. You’re largely in the clear, though exceptions exist for younger patients and those with non-calcified plaque.

• Score of 1 to 100 (Mild Risk): Indicates minimal plaque. This might prompt your doctor to recommend more aggressive lifestyle changes or preventive medications (like statins).

• Score of 101 to 400 (Moderate Risk): Suggests moderate plaque accumulation. Your doctor will almost certainly recommend statin therapy and close follow-up.

• Score over 400 (High Risk): Indicates extensive plaque and a high likelihood of significant underlying Coronary Artery Disease (CAD).

Data Point: According to the American Heart Association (AHA) and the American College of Cardiology (ACC), a CAC score of zero suggests a very low risk of a cardiovascular event over the next 10 years, allowing for potential de-escalation of preventive therapy. Conversely, a non-zero score often dictates the opposite.

Step 2: Discuss the Power of Statin Therapy

For many people with a non-zero CAC score, the primary medical recommendation will be to start a statin (cholesterol-lowering medication). This isn't just about lowering your LDL ("bad") cholesterol; it's about stabilizing the plaque.

• The Mechanism: Statins can help stabilize the existing plaque in your arteries, making it less likely to rupture and cause a heart attack or stroke.

• The Data: A large 2024 meta-analysis published in the Journal of the American College of Cardiology found that individuals with a positive CAC score who were treated with statins experienced a significantly lower rate of heart attacks and all-cause mortality compared to those who were not.

If your score is between 1 and 99, your doctor will likely recommend a moderate-intensity statin along with aggressive lifestyle changes. If your score is 100 or greater, a moderate to high-intensity statin is typically advised.

Step 3: Implement Non-Negotiable Lifestyle Changes

Medication helps, but lifestyle changes are the foundation of heart health—especially after receiving a non-zero score.

Focus on Diet: The Mediterranean Approach

• Eliminate: Processed foods, excessive sugars, and trans fats.

• Boost: Vegetables, whole grains, nuts, seeds, and lean proteins (especially fish rich in Omega-3s).

• Statistic: The Mediterranean Diet is widely cited by the National Institutes of Health (NIH) as being associated with a 30% reduction in cardiovascular event rates.

Prioritize Movement, Not Just Exercise

You don’t have to run a marathon. You just need to move consistently.

• Aim for 150 minutes of moderate-intensity activity per week (a brisk walk counts!).

• If you have a sedentary job, set an alarm to stand and move every hour.

Manage the Silent Killers

A non-zero score means you must aggressively manage stress and prioritize sleep.

• Sleep: Poor sleep is a cardiovascular risk factor. Aim for 7-9 hours of quality sleep per night.

• Stress: Chronic stress elevates cortisol and inflammation, accelerating atherosclerosis. Find a stress-reduction tool that works for you, whether it's meditation, gardening, or simple deep breathing.

Your Journey Starts Now

Getting a non-zero CAC score is a gift: it gives you the knowledge to fight back. It empowers you to have a focused discussion with your doctor and make concrete, life-extending changes. Don't look at the number as a failure; look at it as a roadmap to a longer, healthier life.

Have you had a Coronary Calcium Scan? Share your experience and any successful lifestyle changes you made to help others on their heart health journey!

Disclaimer: This article is for informational purposes only and does not constitute professional medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or before making changes to your health regimen.