In this article, I’ll explain how calcification impacts heart health. You’ll also learn all about coronary artery calcium (CAC) scores, what your resulting score means, and find out if it’s possible to lower a high calcium score naturally. Spoiler alert…there are many preventative measures you can take! Keep reading to find out more.
Table of Contents
The Link Between Calcification and Heart Health
First, let me explain what calcification is and how it impacts heart health.
You’ve heard of calcium deposits in plumbing, right? Well, essentially, a similar thing can happen inside our bodies when calcium builds up in our “internal plumbing”, meaning the walls of arteries.
This is called calcification and it can occur in many different areas of the body, including within other tissues and organs. When this happens in arteries, it can be very dangerous. Calcification restricts your normal bodily processes, including blood flow, putting you at a higher risk of developing a stroke, heart attack, or other cardiovascular diseases.
The most common type of cardiovascular disease is coronary artery disease, also called CAD. And the most common cause of CAD is a condition called atherosclerosis (the build-up of plaque within arteries). As this condition worsens, arteries can become completely blocked, or pieces of plaque can break off and block blood flow to your heart (leading to heart attack) or to your brain (leading to stroke).
This disease process is also called atherosclerotic cardiovascular disease, or ASCVD.
The plaque that leads to atherosclerosis does not only consist of calcium deposits. They are an accumulation of cholesterol, fatty substances, cellular waste products, calcium, and a clotting material in the blood, called fibrin.
The BIG problem with atherosclerosis is that those with early CAD don’t usually have symptoms. So all of these events could be prevented with early detention.
This is where CAC testing is beneficial and highly recommended!
What Is A CAC Score?
Coronary artery calcium (CAC) testing was created as a way to measure one’s level of plaque build-up within arteries, particularly in individuals with no symptoms of coronary artery disease. This makes CAC scoring one amazing development in the early detection and prevention of CAD!
Studies show that in individuals already with symptoms of CAD, there is no significant use for obtaining a CAC score.
Calcium Score Guidelines
Global CAC guidelines vary slightly from one country to another. But a few things stand true no matter which country you are from.
- Most guidelines agree that CAC scoring is crucial to assess and classify the cardiovascular risk in specific individuals.
- This testing can help facilitate a patient and physician relationship and develop an appropriate plan of care moving forward.
- It can help quantify the need for statins, aspirin, antihypertensive therapy, and/or CAC rescanning time intervals.
- The most valuable part of testing your CAC is that your result will help you in your decision on whether or not you need to start a statin medication.
These guidelines mention starting medication, but the original question was how to lower your calcium score naturally. Don’t worry, we’re getting there.
Testing Your Calcium Score
If your doctor mentions the need for a calcium score test, jump on this opportunity!
As I mentioned above, coronary calcium score testing is an excellent test for those without any symptoms of heart disease but that have an intermediate risk of developing heart disease. This includes individuals who may have multiple risk factors, such as older age, family history of heart disease, high cholesterol levels, high blood pressure, or diabetes.
It may also be recommended for those with any of the above-mentioned risk factors along with chronic inflammatory conditions (e.g., rheumatoid arthritis, lupus), or individuals with a history of radiation therapy to the chest
For these individuals, a coronary calcium score can better determine your risk and guide treatment decisions. For example, a high calcium score may warrant more aggressive preventive measures. And a low or zero score may provide reassurance and influence treatment decisions.
Other Names For a CAC Test
There are other names for this test. Some of these include:
- Coronary Calcium Scan
- Coronary Calcium Scoring Test
- Coronary Artery Calcium (CAC) Score Test
- Agatston Score Test
- Calcium Scoring Test
- Calcium Scan Test
- Cardiac CT Calcium Test
- Cardiac Calcium Test
- Calcium Coronary Angiography
- Coronary Calcium Assessment
If a CAC test is not warranted, it may be because you are at higher risk or have clear symptoms of cardiovascular, like chest pain or shortness of breath. In this case, your doctor may want you to perform a stress test. For more information on stress tests, read “Can You Eat Before a Stress Test?“
When To Get a CAC Scan
A study by the American College of Cardiology recommends that men with diabetes get a CAC test done at age 37 years. While women with diabetes get this test performed at 50 years of age.
If you have no symptoms or risks of premature heart disease, a CAC test is recommended at age 42 for men and age 58 for women.
Additionally, if you are a smoker, have a family history of heart disease, or have high blood pressure or cholesterol, you may need a CAC test earlier than people who do not have any risk factors.
How To Prepare For a Calcium Score Test
A CAC test is done using a non-invasive imaging test, called a CT scan or coronary computed tomography angiography (CTA). This shows images of what your arteries look like on the inside.
Before your scan, you will likely need to fast for a few hours before. This means avoiding anything to eat or drink, especially avoiding caffeine or certain medications that may interfere with test results.
You should also wear comfortable clothing without metal objects (e.g., zippers, jewelry) which can also interfere with the imaging.
During and After Your Calcium Score Test
During the scan, you will lie on a table that slides into a CT scanner. The technician will attach electrodes to your chest to monitor your heart’s electrical activity. You will need to remain still and hold your breath for short periods to minimize your movement during the scan.
The CT scanner uses X-rays and computer technology to capture detailed images of your heart and arteries. It takes a series of cross-sectional images or slices, which are then combined to create a three-dimensional image of your heart.
The actual test will take about 10-15 minutes to complete.
Using special software, your CAC score is calculated based on the density and amount of calcified plaque in your coronary arteries. The Agatston score is commonly used to quantify the calcium score. It provides a numerical value that indicates how severe your calcium buildup is.
Once the scan is complete, a radiologist will interpret the images and calculate your score. The score is categorized into different ranges, such as low, moderate, or high.
And finally, your healthcare provider will discuss the results of your coronary calcium score with you. They will explain what your score means and provide recommendations for further testing or lifestyle modifications that may help you.
Calcium Score Chart
The most commonly used scoring system for CAC testing is the Agatston score. This quantifies the amount of calcium detected in the coronary arteries. It is calculated based on the density and area of calcified plaque.
To put it simply, the higher your CAC score, the higher amount of calcification you have in your arteries. Below you will find a chart of what your score means and the treatment recommendation your doctor may prescribe.
What Causes A High Calcium Score?
The short answer to this question is the formation of plaque in your arteries.
Though, if you are looking at the much larger picture, a high calcium score is caused by multiple factors. These include dietary and lifestyle habits that contribute to plaque build-up over time.
Following a poor diet with a minimal intake of fruits, vegetables, and fiber along with a high intake of added sugars, saturated fat, and cholesterol can contribute to plaque build-up in artery walls.
Additionally, lifestyle factors including smoking, lack of exercise, alcohol consumption, poor sleep quality, and high stress levels, put you at higher risk.
And finally, conditions that are beyond your control can also increase your odds of plaque build-up. These include age, gender, and hereditary factors.
Life Expectancy With High Calcium Score
Is a high calcium score a death sentence? Not entirely. The life expectancy of someone with a high calcium score varies greatly and depends on the many factors mentioned above.
There are lifestyle and dietary changes you can make to reduce your chances of having a serious heart event and death.
Diet For High Calcium Score
While there is no diet to reduce coronary calcium specifically, following a heart-healthy diet is your best bet at preventing further damage.
Diets such as the DASH diet and Mediterranean diet are endorsed by the American Heart Association and the American College of Cardiology. These diets help prevent coronary artery disease and improve overall heart and cardiovascular health. Let’s go over some of these recommendations in more detail.
And for a free heart-healthy grocery shopping list, visit my RD2RD shop.
Increase Fruit and Vegetable Intake
Including a variety of fruits and vegetables in your diet will add essential antioxidants, fiber, and other important nutrients to protect you from heart disease. Aim for at least five servings per day to promote heart health. And get a variety each week, including all colors of the rainbow, as each color is associated with certain health-benefitting phytonutrients.
Choose Whole Grains
Whole grains are notorious for promoting the health of your gut and your heart. The USDA’s MyPlate guidelines encourage us to make half of our grains “whole”.
This means choosing whole grains such as whole wheat, brown rice, quinoa, and oats instead of refined grains which are more processed. Whole grains are higher in fiber and can help reduce cholesterol levels and support heart health.
Limit Saturated and Trans Fats
Saturated and trans fats can raise cholesterol levels and contribute to arterial plaque buildup. Therefore, we need to avoid or limit these types of foods. Examples of these foods include fried foods, processed snacks, fatty cuts of meat, and full-fat dairy products.
As a guideline, individuals that are at risk for heart disease or have high cholesterol need to limit saturated fat intake to less than 6% of their daily calories. This is around 13 grams or less of saturated fat per day if you follow a 2,000 calorie diet.
Include Healthy Fats
Monounsaturated and polyunsaturated fats, on the other hand, do not contribute to atherosclerotic heart disease. In fact, studies show that these types of fats can help reduce inflammation and improve cholesterol levels. They also contain essential omega-3 and omega-6 fatty acids that we cannot produce ourselves.
Monounsaturated fats include foods such as avocados, nuts, seeds, and olive oil. And polyunsaturated fats include foods such as corn oil, safflower oil, sunflower seeds, walnuts, and soy products like tofu.
Choose Lean Protein Sources
Lean protein sources like skinless poultry, fish, beans, legumes, and tofu can help prevent heart disease and plaque in arteries as well. These options are lower in saturated fat compared to red meat and are great sources of protein and other nutrients.
I strongly encourage you to eat more plant-based proteins that are minimally processed. For some healthy and exciting options, check out this post on “The Best Alternatives to Deli Meat (Plus 13 Yummy Recipes)“.
Minimize Sodium Intake
You may already know that limiting sodium can help decrease blood pressure, which is correct! I tell heart patients often, “Where salt goes, water follows”.
Excessive sodium intake harms your heart by leading to increases in blood volume and blood pressure.
You can minimize sodium consumption by avoiding high-sodium processed foods, canned soups, and fast food. For many lower-sodium recipe ideas, check out my recipe page. Or for a handy low-sodium shopping list, check out “Low Sodium Grocery List for a Heart-Healthy Diet (Free PDF)“.
Include Omega-3 Fatty Acids
When we talked about including healthy fats, we mentioned omega-3 fatty acids. These types of fatty acids are especially important for protecting heart health. They can decrease inflammation and aid in brain health as well as cardiovascular health.
You can include omega-3 fatty acids by eating fatty fish such as salmon, tuna, sardines, and mackerel. Alternatively, you can take fish oil supplements. And if you follow a vegan diet, algal oil supplements are also available.
I highly recommend trying Barlean’s brand omega-3 fish oil supplements and plant-based omega-3 supplements. They’ve been in the biz for years and make high-quality, sustainably sourced supplements.
For more on the importance of omega-3 fatty acids and where to find Barlean’s supplements, read “Getting Omega-3’s With Barlean’s (Product Reviews and Recipes)“.
Limit or Avoid Alcohol Consumption
If you drink alcohol, do so in moderation or avoid it altogether. Moderate alcohol consumption is defined as up to one drink per day for women and up to two drinks per day for men. However, more than this amount can contribute to high blood pressure and other heart-related problems.
For more on how alcohol affects heart health, read “The Truth Behind Alcohol and Sudden Cardiac Death“.
Lifestyle Changes To Improve Calcium Score
Now that you know what to include and limit in your diet, let’s discuss lifestyle choices to lower your calcium score naturally.
First, there is smoking. This also includes other forms of nicotine, including e-cigarettes, cigars, and vape products. Even marijuana intake has been found to increase the risk of serious cardiac events by making pre-existing issues with arterial plaque build-up worse.
The same negative effects can be brought on by smokeless tobacco (chewing tobacco) and secondhand smoke as well.
For more on the health risks of smoking and tips to quit, read “How Can Refraining From Smoking Benefit an Individual’s Health?“.
Get Some Exercise
I think we all know that cardiovascular exercise is beneficial to improving heart health. To improve heart health, you need at least 150 minutes per week of moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.
If you have not been physically active for some time, you should always talk to your doctor before starting an exercise program. If you put too much strain on your heart, it could result in severe chest pain or a serious cardiac event.
For most people, walking is a great start to getting your daily physical activity needs.
Manage Your Weight
Having excess body weight (AKA obesity) leads to an increase in many chronic diseases including cardiovascular disease, chronic kidney disease, and diabetes among others.
Because of this, major organizations still emphasize the importance of maintaining a normal body weight which reduces your risk of cardiovascular disease. However, even those with normal body weight can be at high risk if they have other risk factors present.
In addition, it’s important to mention that body mass index alone is not a good indicator of health status. In the case of cardiovascular health, waist circumference and body composition should also be assessed.
Get Adequate Sleep
Sleep is essential for more than helping us think throughout the day. It’s important for maintaining our metabolic function.
For more on why sleep is so important and tips on how to get more, read “Why Sleeping Is Important for Health [And How To Get More!]“.
Manage Stress Levels
And finally, high stress levels can indirectly cause plaque build-up in arteries. This is because when you feel stressed, you may be more likely to engage in other high-risk behaviors.
Long-term emotional stress can also lead to increases in cortisol levels. Cortisol is your “fight or flight” hormone. Too much cortisol can elevate blood pressure, blood sugar, and cholesterol levels, which increases your risk for heart disease.
For more on how to manage stress levels, read “Maintaining a Healthful Diet During Times of Stress“.
Research shows that signs of early blockage can be detected in children as young as 10-14 years old. The process worsens as we age and symptoms may not be noticed until 40-50 years of age.
The ACC and AHA recommend that patients with coronary artery calcium scores of 1 to 99, have a discussion with their doctor. If these patients remain untreated, a repeat CAC test may be repeated in 5 years, however, the data on the value of doing so is limited.
Calcium score tests are a reliable tool for assessing the presence and extent of calcified plaque in your coronary arteries. However, there are still limitations to this test. For example, CAC tests do not show the amount of soft plaque in your arteries, or assess blood flow. Because of these limitations, it’s possible to receive both false positives and false negatives. Other tests may be needed to fully assess your risk and degree of cardiovascular disease.
Both provide complementary information. A stress test is more focused on evaluating the heart’s response to exercise and assessing blood flow. On the other hand, a coronary calcium score test shows the amount of calcified plaque in your coronary arteries.
Ultimately, the choice of which test to use depends on your individual’s symptoms, risk factors, and the specific clinical question that needs to be addressed. A healthcare provider will consider these factors and help you determine the most appropriate test or combination of tests to provide accurate diagnostic information.
Coronary artery calcium (CAC) testing is an excellent test to detect early heart disease. If you have several risk factors for heart disease but no current symptoms, it may benefit you. Your doctor will take into account your overall risk profile, medical history, and specific clinical circumstances to determine whether the test is appropriate for you.
Once your results are interpreted, it will give a much clearer picture of the health of your arteries. Clear and open arteries will mean a lower calcium score, while a higher score means you are at higher risk of developing blockages which could lead to heart attack, stroke, or other cardiovascular diseases.
While there are no clear recommendations on how to lower your calcium score naturally, dietary and lifestyle changes can slow and prevent progression of calcification. However, for some individuals, medication may still be recommended by your doctor, including statins, aspirin, or blood pressure medication.
For more information on how to reduce your risk of atherosclerotic cardiovascular disease, I highly recommend reading “5 Things You Can Do to Support Heart Health NOW“.
And visit the American Heart Association website to brush up on “Life’s Essential 8” which can be used as a checklist for better heart health.
❤️Use the interactive ASCVD risk calculator while you’re there!
Kiran Campbell is a registered dietitian and entrepreneur with 13 years of experience. She has a degree in psychology as well as dietetics. She is also a proud member of the Academy of Nutrition and Dietetics’ and its Cardiovascular Health and Well-being Dietetics Practice Group among others. Kiran proudly presents and promotes the most up-to-date, science-based nutrition information on all things heart-related. She aims to serve not only individuals with heart disease, but also those wanting to protect against it. Learn more about Kiran by visiting her About Page.