Did you know that your calcium score could hold the key to understanding your heart health? Whether it’s high or low, this number offers valuable insight into your risk of developing heart disease, and understanding your score can empower you to take proactive steps toward a healthier future.
During a recent conversation on the HealthspanMD Podcast, Dr. Robert Hurst sat down with Dr. Michael Eckersley, a cognitive psychologist and professor at the University of Kansas, to discuss one of the most overlooked (but powerful) tools in preventive cardiology.
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Now, let’s explore what your calcium score really means and why it matters for your long-term health.
What Is a Coronary Artery Calcium Score?
A coronary artery calcium (CAC) score is a non-invasive test that measures the amount of calcified plaque in the coronary arteries, which are the vessels that supply blood to your heart. It’s performed using a CT scan and produces a numerical score that reflects the burden of calcium in your artery walls.
This calcium is a marker of atherosclerosis, or hardening of the arteries. While it’s not the calcium itself that causes heart attacks, its presence is a clear sign that plaque has built up over time. As Dr. Robert Hurst explains in the podcast, “We’re looking for calcium, but calcium isn’t the problem. That’s old, healed artery disease. It’s easy to see, and it’s very predictive of outcomes.”
A higher score means more plaque and a higher risk of future heart events like heart attack or stroke. A score of zero indicates no detectable calcified plaque and is generally associated with low short-term risk. Scores in the hundreds or more, like the 700 Dr. Michael Eckersley received, indicate a significantly increased risk, even in people who feel perfectly healthy.
As Dr. Hurst puts it, this type of early detection can be a blessing: “Instead of finding out you were more likely to have heart issues because you had a heart attack, you found out because you had a CT scan. That’s huge.”
What Does a Low Calcium Score Mean?
A low coronary artery calcium (CAC) score (particularly a score of zero) is generally considered very reassuring. This means that the CT scan detected no visible calcified plaque in the coronary arteries. For most people, especially those without symptoms or major risk factors, a zero score indicates a low short-term risk of heart attack or other cardiovascular events.
That’s why the CAC test has become such a valuable screening tool in preventive cardiology. It gives a clear signal: if your score is zero, you’re very unlikely to have significant artery disease right now.
But it’s important to understand that a low score doesn’t equal zero risk. People who are younger, or who have risk factors like diabetes, high blood pressure, or a family history of heart disease, may still have non-calcified (soft) plaque that won’t show up on a CAC scan. In those cases, further testing or risk assessment may still be warranted.
In short, a low score means:
- You likely have minimal atherosclerosis, if any
- Your risk of a heart event in the near term is low
- It’s the ideal time to stay proactive and maintain good health habits
If your score is low or zero, it’s your green light to double down on prevention, not a reason to stop paying attention. Maintaining your metabolic health, physical fitness, and inflammation markers can help keep your arteries clear and your long-term risk low.
What Does a High Calcium Score Mean?
A high coronary artery calcium score (typically defined as 100 or greater, and especially 400 or higher) means there is significant calcified plaque in the coronary arteries. This is a red flag that artery disease has been developing silently over time, even if you’ve never experienced symptoms.
For Dr. Michael Eckersley, the news was both shocking and confusing. Despite running regularly, maintaining low cholesterol, and following a healthy lifestyle, he received a CAC score of 700. “Of course, I didn’t know exactly what a 700 score meant,” he says. “So, I went online and found all kinds of information […] and realized I was on the higher end of things.”
Unfortunately, many people in this situation walk away from their doctor’s office with little clarity, or worse, with no action plan. That was Dr. Eckersley’s experience, too: “[The doctor] didn’t really tell me anything I hadn’t more or less found out online, and he didn’t seem to provide me with any specific treatment plan […] I was kind of in a problematic situation.”
But here’s the crucial point: a high calcium score isn’t a death sentence. It’s an opportunity.
Dr. Hurst emphasizes this throughout the episode: “We’re really good at stopping artery disease and even regressing it […] You were insightful enough to say, ‘Okay, I’m going to pay the $100 to get the test.’ Then you got this result. And that was a blessing.”
A high CAC score means:
- You have existing plaque and are at increased risk for cardiovascular events
- Aggressive prevention is needed: this may include medications, targeted exercise, and advanced testing
- Even if you otherwise appear healthy, there's a hidden risk
What it does not mean is that you’re doomed. In fact, discovering a high CAC score before a heart event occurs gives you the chance to intervene early and effectively.
Dr. Eckersley took that path. After his diagnosis, he began strength training, addressed underlying health drivers, and embraced a more comprehensive strategy for heart health. “I feel positive enough about my prospects that I’m not at all depressed […] I’m pretty confident that there’s a future for me.”
Why Your Score Matters
Whether your CAC score is high or low, it provides a powerful snapshot of your cardiovascular health, but what you do with that information makes all the difference.
A low score often gives people peace of mind, but it shouldn’t lead to complacency. It’s a sign that your arteries are likely free of calcified plaque, and your short-term risk is low, especially if you don’t have other major risk factors. But low doesn’t mean zero risk. The best use of a low score is as motivation to maintain healthy habits that keep your arteries clear for the long haul.
On the other hand, a high score can be jarring, especially if it’s unexpected. Many people, like Dr. Eckersley, discover a score in the hundreds despite eating well, exercising regularly, and managing their cholesterol levels. That’s exactly why the context around your score is so important.
- A low score may mean you can avoid medications, but should still follow a prevention-focused lifestyle.
- A high score may prompt more intensive action, like statins, strength training, further cardiac testing, or metabolic optimization.
- Misunderstanding either score can lead to a false sense of security or unnecessary panic.
- Your score isn’t the whole story; it’s a tool to inform a personalized prevention strategy, not a standalone diagnosis.
Ultimately, the CAC score is not a test of fate, but rather a test of opportunity. When interpreted correctly, it tells you whether you’re currently on the right track or whether there are hidden risks that need addressing. In either case, it’s a chance to take control.
As Dr. Eckersley shared, it’s easy to spiral when you see a high number, but guidance from a team focused on long-term health can make all the difference. “You have to stay fairly positive so that it doesn’t become overwhelming,” he says. “There’s a different track than standard cardiology… You just need the right direction: clear objectives, clear path.”
When to Seek Specialized Care
If you've received a high calcium score and walked away without a clear plan (or worse, with no real explanation) you’re not alone. Many people find themselves in this exact situation: anxious, confused, and unsure of what to do next.
Here’s when it’s worth getting a second opinion:
- You’ve received a high CAC score but no clear prevention strategy
- You’re being offered invasive procedures without non-invasive assessments
- You’ve been told to “wait and see” despite feeling anxious or motivated to act
- You want a whole-body, proactive approach to cardiovascular risk, not just prescriptions
At HealthspanMD, we believe that early detection only matters if it leads to effective action. Our approach combines advanced diagnostics (like CAC scoring, VO₂ max testing, and DEXA scans) with tailored strategies for muscle building, metabolic health, and cognitive preservation.
If your current care team isn’t addressing these areas, it’s time to find one that will.
Get Started with HealthspanMD
At HealthspanMD, we don’t just react to disease; we help you get ahead of it. Whether your goal is to prevent a first heart event or build strength and confidence after a high calcium score, we’re here to provide the expertise, tools, and support you need to thrive.
Don’t wait to prioritize your health. Schedule a call with HealthspanMD today to learn how our expert team can guide you toward improved well-being and long-term vitality.
