Heart, metabolismAgatston
Coronary calcium (CAC) score
Optimal
0; 1–99 mild, 100–399 moderate, ≥400 extensive
Why
The one test that shows disease already laid down, not just risk. A score of 0 means <1% 10-year event risk (a statin can be deferred); above 100 treatment is warranted regardless of age. It misses soft, not-yet-calcified plaque.
How often
Once between 40 and 50 (women 45–55); if 0, repeat after 5 years. Low-dose CT (~1 mSv).
What moves it
Existing calcium doesn't vanish; the aim is halting further deposition: ApoB < 60, blood pressure < 120, quitting smoking, vitamin K2 (debated).
Last reviewed: 6 September 2026
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