Your heart can look calm on the outside while trouble builds in silence. That is the strange part about plaque. It can grow for years without warning signs, like rust spreading inside a pipe.
A CAC score (coronary artery calcium score) helps spot that hidden buildup. It does not predict your future with certainty, but it can sharpen the picture. If you care about healthy nutrition, training, and a longer life, this is one test worth understanding.
The goal is simple: know what the numbers mean (0, 1-99, 100+), know who should ask for it, then take the next step with confidence.
What a CAC score measures (and what it misses)
A CAC score comes from a special CT scan that looks for calcium deposits in the coronary arteries. Calcium acts like a flag for atherosclerosis, the plaque process that can lead to heart attack. The scan outputs an Agatston score, which is a total amount of calcified plaque seen.
The key word is calcified. Some plaque is soft and not yet calcified, so a CAC scan can miss early disease. Still, calcium is meaningful because it tends to track with overall plaque burden. That is why clinicians use it to refine prevention choices, often when the decision about medication feels uncertain.
Most people get this scan without contrast dye. The test is quick, and you do not need recovery time. It is not meant for emergency symptoms. If you have chest pain, shortness of breath, or new exercise limits, you need a medical evaluation, not a screening scan.
For a clear patient overview of what the test is and why it is used, see coronary artery calcium scoring basics.
A CAC score does not measure how “blocked” an artery is today. It measures calcified plaque, which helps estimate overall risk.
CAC score numbers explained: 0, 1-99, and 100+
Think of calcium like ash after a fire. You may not see flames now, but you know something has burned before. The higher the score, the more evidence of plaque.
Here is a simple way to read the most common categories. This table sets context, then the takeaway follows.
| CAC score range | What it usually means | Common prevention focus |
|---|---|---|
| 0 | No coronary calcium detected | Lifestyle first, meds often deferred if overall risk is low |
| 1-99 | Mild plaque | Tighten lifestyle, discuss statins based on age and risk factors |
| 100+ | At least moderate plaque burden | Statins are often recommended, add aggressive risk reduction |
CAC score of 0: This is the “clean scan” result. It often means your short-term risk is low. Many guidelines allow people at borderline or intermediate risk to hold off on statins, while doubling down on habits. Some clinicians consider repeating the test in about 5 to 10 years, depending on your situation.
CAC score 1-99: A small number still matters. It means plaque exists, even if you feel great. In practice, this range often pushes people to take prevention more seriously, because the process has started. Age matters here. A score of 25 at 45 can carry a different message than 25 at 70.
CAC score 100+: This is the line where prevention usually gets more intense. Many sources break this down further (100-300 moderate, 300-400 higher, and above that extensive). You may see those ranges described in clinical pages like University of Maryland’s cardiac calcium scoring guide. The point stays the same: more calcium usually equals more overall plaque and higher risk.
Who should ask for a CAC test, and what to do after you get results
CAC testing fits best for people who are not having symptoms, but whose risk is not crystal clear. Many guidelines focus on adults ages 40 to 75 with borderline or intermediate 10-year risk, when the statin decision is uncertain. The American Academy of Family Physicians summarizes this role in prevention in its CAC scoring review.
You might also consider asking if you have a strong family history of early heart disease, or if your labs and lifestyle do not seem to “match” your risk. Athletes are not immune to plaque, so high fitness does not cancel genetics.
Once you have the result, match action to the number:
- Review the full risk picture with your clinician (blood pressure, lipids, diabetes, smoking, family history).
- Talk through medication if CAC is above zero, and especially if it is 100+. Statins often enter the conversation here.
- Build a prevention routine you can repeat, not a two-week burst.
Food and movement are still the foundation. A heart healthy diet is not one magic ingredient. It is a pattern: fiber-rich plants, unsaturated fats, and less ultra-processed food. Keep healthy food visible and easy, because convenience wins when you are tired. If you want practical meal ideas, this heart-healthy foods guide is a strong starting point.
Your plate also supports your lab results. A steady healthy food diet can improve non-HDL cholesterol and triglycerides, which matter for plaque risk. For a structured approach, the lower non-HDL cholesterol food plan can help you turn intent into meals.
Movement matters too, but it does not need to be extreme. Aim for a healthy living diet and exercise rhythm you can keep all year. Brisk walking, cycling, swimming, and strength training all count. Over time, sports and exercise for long life look more like consistency than hero workouts.
If your CAC score is higher than you expected, do not panic. Use it as a loud reminder to practice prevention every day.
This is where healthy nutrition becomes practical: more fiber, more plants, smarter fats, and less added sugar. That is also real nutrition to prevent illness, the slow work that protects your future self.
Conclusion
A CAC score turns an invisible problem into a number you can act on. A score of 0 often supports lifestyle-only prevention, 1-99 means plaque has started, and 100+ usually calls for stronger steps with your clinician. Pair the result with a heart-smart routine built from movement and repeatable meals, then re-check progress over time. Your next choice at the grocery store or on a walk can be small, but it can still move the story in the right direction.
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