The Coronary Artery Calcium (CAC) score assesses an individual’s risk of a future cardiovascular event. This score directly measures the amount of calcified plaque buildup within the heart’s arteries, which is a key indicator of atherosclerosis. For men aged 70, understanding this score offers insight into their accumulated plaque burden and guides personalized preventative strategies. This article provides context for the CAC score, interprets its meaning, and outlines the steps following a test result for this demographic.
Defining the Coronary Artery Calcium Score
The CAC score is determined through a non-invasive procedure called a cardiac computed tomography (CT) scan, which requires no intravenous contrast dye. The CT scanner captures cross-sectional images of the heart, allowing clinicians to visualize and quantify the dense calcium deposits in the walls of the coronary arteries. These deposits represent hard, stable plaque that has developed over many years and serve as a marker for the overall presence of coronary artery disease.
The final result is reported using the Agatston scoring method, the standard measure in clinical practice. The Agatston score is calculated by multiplying the area of each calcified lesion by a density factor. A higher Agatston score signifies a greater volume and density of calcified plaque, correlating with a higher atherosclerotic burden.
Typical Calcium Scores for Men Over 70
For a 70-year-old man, the presence of coronary calcium is common and expected due to the natural progression of atherosclerosis over a lifespan. Population studies, such as the Multi-Ethnic Study of Atherosclerosis (MESA), provide reference values to help contextualize an individual’s score. These reference values are often presented as percentiles, which compare a person’s result to others of the same age and sex.
A 70-year-old man’s score is compared to the 70-79 age bracket, where the average score is significantly higher than in younger groups. The 50th percentile, which represents the median score for men in this age group, typically falls in the range of 200 to 300 Agatston units. This means that half of all men aged 70 to 79 will have a score at or below this value.
A score exceeding the 75th percentile, often above 400 Agatston units, indicates a higher-than-average amount of calcification. A score in the 90th percentile, which indicates a high plaque burden compared to peers, can often exceed 800 Agatston units. Interpretation must consider these percentile rankings, as a score that is high for a younger person may be considered typical for a 70-year-old.
Interpreting Calcium Score Ranges and Associated Risk
The CAC score is most often interpreted using established absolute thresholds that relate directly to the risk of a heart attack or stroke. A score of zero is the most favorable result, indicating no detectable coronary calcium. This is associated with a very low risk of a cardiovascular event over the next 10 to 15 years and suggests the individual is unlikely to benefit from preventative medications.
Scores between 1 and 100 represent mild calcification and are associated with a low to intermediate risk of future cardiac events. This finding confirms the presence of atherosclerosis and suggests a need for aggressive risk factor management through lifestyle changes. The next range, from 101 to 400, signifies moderate plaque accumulation, placing the individual in an intermediate to high-risk category that often warrants a more aggressive medical treatment plan.
A score exceeding 400 Agatston units is considered extensive calcification and corresponds to a high risk of a future cardiovascular event. For men at age 70, a score in this high range clearly indicates a significant amount of plaque has built up, necessitating comprehensive medical intervention.
Next Steps After Receiving Your Score
The action taken after a CAC test is primarily determined by the absolute score and its corresponding risk category. For a 70-year-old man with a score of zero, the focus remains on maintaining a heart-healthy lifestyle, including regular physical activity and a balanced diet. In the absence of other high-risk factors like diabetes or a strong family history of premature heart disease, preventative medications like statins may be safely deferred.
If the score falls in the 1 to 100 range, lifestyle modifications are paramount, but physicians may also consider starting statin therapy if the patient has other cardiovascular risk factors. For any score above 100, current medical guidelines strongly recommend initiating statin therapy to lower cholesterol and reduce overall cardiovascular risk, as this score indicates a substantial atherosclerotic plaque burden.
Men with very high scores, especially those above 400, may be considered for additional medications beyond statins, such as low-dose aspirin, following a discussion of potential bleeding risks. A significantly high CAC score may also prompt a cardiologist to order further non-invasive testing, such as a stress test, to check for flow-limiting blockages. The CAC score provides an opportunity for the physician and patient to engage in shared decision-making regarding the most appropriate treatment plan.