Significance of a cardiac calcium score

DEAR DR. ROACH: I would like to know about the interpretation of the cardiac calcium test. My husband and I (both 74 years old) had this test and got scores of 74th and 77th percentiles, respectively. Our cardiologist did not seem very impressed with the test or our scores, and said the results may mean a 5 per cent chance of a heart event each year. He indicated that this was low, especially since we had both had done quite well on our stress tests, which we take annually as part of our general checkup of cardiac health.

After doing a lot of online research, we could not find anything we could do proactively to reduce our scores except lose weight (both of us have very reasonable body weight) and increase aerobic exercise.

Although we both are quite active and eat well, we do not exercise aerobically, just motion and stretching exercises. May I stop worrying about the 5 per cent chance a year of a heart event?

ANSWER: Five per cent per year is an absolute number, but my interpretation may be different from your cardiologist’s. He seems to think it’s OK, but I think 5 percent is too high, and I would encourage you to make what changes you can.

Eating well is a great goal, but most people are able to improve their heart disease risk further through diet. It’s becoming clear that a diet based mostly on plants and legumes, with nuts, some fruits, whole grains and almost no refined sugars and starches, reduces heart disease risk. I believe that a diet including fatty fish has low heart disease risk compared with a vegan diet, but others disagree and the evidence is not absolute.

There are many stress-reduction techniques that are helpful for people with high stress.

A statin drug and aspirin would be recommended for nearly all people with calcium scores like you have.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.