What You Should Know about Coronary Calcium

You want calcium in your bones, not in your arteries

A CT scan can determine your coronary calcium score

For a heart-healthy diet, real food is always better than processed

Calcium is good for building strong bones, muscles and teeth, but when it comes to the arteries of your heart, it’s actually a bad thing. Sound confusing? Coronary calcium is a topic you may not know much about, but you should if you want to stay on top of your heart health. James Beckerman, MD, a cardiologist and medical director of prevention at Providence Heart & Vascular Institute in Portland, OR, explains what coronary calcium is all about.

What is coronary calcium?

This occurs when calcium forms within the walls of coronary arteries. That’s a sign that there is plaque calcified, or hardened, there. “Calcium is a marker for atherosclerosis,” says Dr. Beckerman. And that’s why coronary calcium is bad for your health — the plaque buildup of atherosclerosis can hamper blood flow to the heart and lead to heart attack or stroke.

How do you know if you have it?

Coronary calcium is detected through a CT scan, which takes X-ray images of the heart to detect the presence of calcium deposits in the walls of the blood vessels, Dr. Beckerman says. “Once you have this test, a computer is able to evaluate the severity and extent of the calcium you have and you are given a numerical score.” A normal score is zero, which means there is no calcium in the artery walls, but it can go up a lot higher than that depending on the amount of calcium that’s there.

What does the score tell you?

The score can help you and your doctor know if you have a higher risk of heart attack and stroke. “It’s a pretty definitive way of saying you do have coronary artery plaque,” Dr. Beckerman says. “So if you are someone who is on the fence about taking cholesterol medication, for instance, and you have this test and it says you have the beginning of coronary artery plaque, it could lead you to change your lifestyle, adapt different behaviors or get different treatments, such as taking the medication.”

So should everyone get the heart CT scan?

Not necessarily, according to Dr. Beckerman. The people who benefit most from the screening are those at intermediate risk for coronary problems. “If you’re a low-risk person — you’re 25 years old and have no risk factors for heart disease — this test would never be recommended,” he says. “If you’re in a high- risk group — you’re an older person who has smoked and you have diabetes — there are already a lot of treatments you’ll be on for those conditions and the test won’t change how we tell you to take care of yourself.”

But say you’re in between those two groups — you’re in middle age with high blood pressure and increased cholesterol, but otherwise you are in good health. “Doctors recommend this test more for those people, for whom the results might shift the way they think about this,” Dr. Beckerman says. “A score of zero would provide them with some level of reassurance, but on the other hand, an elevated measurement might lead them to pursue risk reduction with a more aggressive approach.”

Dr. Beckerman adds that there are financial considerations as well because in many cases insurance doesn’t cover this screening test. Also, the test does involve some radiation exposure. “At the end of the day, if you find yourself in the intermediate risk profile or have concerns about certain kinds of medication to reduce heart disease risk, it’s possible a conversation with your doctor about the test might help to move your thinking in one direction or another.”

Is coronary calcium affected by the calcium you eat?

There doesn’t seem to be a correlation between high calcium intake and high coronary calcium levels when it comes to the food you eat. However, it might be a different story when it comes to supplements; a recent study suggested that while dietary sources of calcium may help lower heart disease risk, calcium supplements could potentially lead to a higher risk of atherosclerosis. When considering taking any supplement, it’s best to consult with your doctor first.

Are there any preventive measures to take?

“People are bombarded with dietary advice and looking for new trends to follow, but the simplest dietary advice is to eat real food,” Dr. Beckerman says. “A lot of people are still eating a lot of processed food, processed meat and food that goes in the microwave before it goes in their stomach. If there is one thing generally to do as a society it would be to eat less of that. That would be heart healthy for everybody.”

If you have more questions about coronary calcium or concerns about your heart health, talk with a physician at one of these locations, or find a location near you:

Oregon: Providence Heart Institute

Washington: Providence Spokane Heart Institute

California: Providence Saint John’s Health Center

Alaska: Providence Heart & Vascular Center

Montana: International Heart Institute

Kadlec: Kadlec Inland Cardiology