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The Princeton Longevity Center Medical News

Tip # 10-  Know Your Calcium Score

Cardiovascular disease is the leading cause of death. And, for at least 1 out of every 3 people who develop coronary disease, their first symptom is sudden death.  

It typically takes 20 years or more for the plaque in your arteries to develop to the point where you are at high risk for heart attacks or strokes.  By the time symptoms develop, you are likely to have advanced disease and the opportunity for avoiding invasive procedures or life-altering illness may have already been lost.  Finding your plaque early means treatment is much easier and more effective.

For the past 40 years we have all been conditioned to worry about cholesterol levels.  But cholesterol is a relatively poor predictor of cardiac risk.  Many people with very high cholesterol levels have clear arteries.  And, more than two-thirds of heart attacks happen in people with cholesterol levels considered “normal”. 

Cholesterol is considered a “risk factor” for coronary artery disease.  Living a healthy lifestyle to try to minimize your risk factors undeniably makes sense.  On the other hand, having a parent with high blood pressure and eating salty foods are two risk factors for high blood pressure.  Yet, none of us would agree to start taking a pill for high blood pressure based on just having those two risk factors without someone actually measuring your pressure and finding that it was actually high.  So, why do we continue to put people on medications to treat coronary artery disease just on the basis of their having 1 or more risk factors without actually checking to see if they have disease in their arteries?

Until recently, we could not tell which person with high cholesterol might have coronary disease requiring medication and which person had clear arteries with very little risk.  Giving drugs to someone who has no detectable plaque and very low risk can’t lower their risk by very much no matter how high their cholesterol might be.  At the same time, we missed many cases of people at high risk because their arteries were loaded with plaque but their cholesterol levels were considered “normal”.

Cardiac CT Scans changed everything.  Now, we can painlessly and non-invasively look directly at the arteries and see how much plaque is present. By measuring the Coronary Calcium Score, the amount of calcium deposits present in the walls of the coronary arteries, we can gauge your heart attack risk as quickly and easily as a blood pressure cuff find hypertension.


Those with extensive plaque are at high risk and need to be treated whether their cholesterol is high or not.  Those with no detectable plaque may be able to avoid medications and just focus on healthy living to try to reduce their risk factors and keep their arteries clear.

Cholesterol levels were the best tool we had in the 20th century.  For 21st century medicine, you need to know your Calcium Score.

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