A “Heart Score” refers to a non-invasive tool that helps assess an individual’s long-term cardiovascular risk. This assessment moves beyond traditional risk factors like age, cholesterol levels, and blood pressure to provide a direct, physical measure of arterial health. It serves as important information for physicians, helping them determine the true level of risk for a heart attack or stroke. Obtaining this score can refine a person’s risk profile, particularly for those with intermediate risk, guiding personalized preventative strategies and treatment plans.
The Coronary Artery Calcium Score Defined
The “Heart Score” most commonly refers to the Coronary Artery Calcium (CAC) score, which quantifies the amount of calcified plaque in the walls of the heart’s arteries. Calcification is a late-stage marker of atherosclerosis, the underlying disease process where fatty deposits build up and harden within the arteries. The presence of this hardened plaque strongly correlates with the overall burden of atherosclerosis and a person’s future risk of a cardiac event.
The score is calculated using the Agatston scoring system. This system takes into account both the area of the detected calcium deposits and the maximum density of the calcium within those deposits. The final number, measured in Agatston units, represents the total volume and severity of calcified plaque. A higher Agatston score reflects a greater amount of physical disease, which significantly increases the associated cardiac risk.
The Testing Procedure
The CAC score is determined using a specialized, non-invasive imaging test called a cardiac computed tomography (CT) scan. The scan is performed without the use of intravenous contrast dye, making it a simple and quick appointment.
During the test, electrodes are placed on the chest to monitor the heart’s rhythm with an electrocardiograph (ECG). The CT scanner captures a series of images synchronized with the heartbeat, which helps minimize motion blur. The entire process is fast, often taking less than five minutes of scanner time, and involves a low dose of radiation. Since this is often considered a screening tool, insurance coverage may be limited, and patients may need to inquire about out-of-pocket costs.
Interpreting Your Score
The CAC score provides a direct visualization of subclinical atherosclerosis, offering four general categories of risk based on the Agatston unit total.
A score of zero indicates no detectable calcified plaque and is associated with an extremely low risk of a heart attack over the next decade. This finding often provides a “warranty period,” suggesting that a major cardiac event is highly unlikely.
A score between 1 and 100 signifies mild calcification and is generally considered a low to intermediate risk level. Scores in the range of 101 to 400 denote a moderate plaque burden, placing the individual into an intermediate-to-high-risk category. This level is associated with a significantly increased risk of future cardiovascular events compared to a zero score.
A score exceeding 400 Agatston units represents extensive calcified plaque and is classified as a very high-risk finding. Individuals in this category have a substantially elevated risk of cardiac events and often require aggressive preventative treatment. The absolute score is also interpreted in the context of the patient’s age and gender through a percentile ranking, as plaque accumulation increases naturally with age.
Implications for Health Management
The CAC score serves as a powerful tool to guide preventative treatment, especially for patients whose traditional risk factors are inconclusive. A score of 0 can often lead to a discussion about not initiating statin therapy, even if cholesterol levels are borderline high, as the risk is so low. This finding can help avoid unnecessary medication for otherwise healthy individuals.
Conversely, a high score often prompts the initiation or intensification of risk-reducing medications. A score of 100 or greater typically leads to a strong recommendation for statin therapy, regardless of the person’s LDL cholesterol level. For very high scores, such as those over 400, physicians may recommend high-intensity statin regimens and consider other preventative measures. The score provides actionable information, helping patients and their doctors make informed decisions about aggressive lifestyle changes, including diet, exercise, and blood pressure management.