Calcium Score
In brief
Section titled “In brief”- The calcium score measures calcifications in the coronary arteries
- Calcium is a scar of previous inflammation, not active disease
- A high score says nothing about current activity of the process
- Lifestyle remains the foundation of prevention
- Medication only for biochemically active risk
What the calcium score means
Section titled “What the calcium score means”The coronary calcium score (CCS) measures calcifications in the coronary arteries. A higher score means that in the past there has been inflammation and vessel wall damage.
Score interpretation
Section titled “Score interpretation”| CCS | Meaning |
|---|---|
| 0 | No indication of atherosclerosis |
| 1-99 | Beginning calcification |
| 100-399 | Clear atherosclerosis |
| ≥400 | Extensive calcification, usually stable plaques |
A high CCS does show atherosclerosis, but says nothing about the activity of the process.
| Lifestyle | Plaque status |
|---|---|
| Healthy lifestyle + low inflammation | Plaques usually stable |
| Metabolic dysregulation | Plaques more likely vulnerable |
The calcium score is thus a risk window, not an emergency signal.
Metabolic remission with residual scars
Section titled “Metabolic remission with residual scars”Even after prolonged remission, residual traces of former metabolic damage remain visible:
| Marker | Meaning |
|---|---|
| Slightly elevated insulin | >7 µU/ml |
| TG/HDL ratio | >1 |
| Calcifications | Limited regression |
Recommended lifestyle
Section titled “Recommended lifestyle”| Pillar | Advice |
|---|---|
| Nutrition | Carbohydrate-restricted (less than 50 g/day), rich in protein and omega-3 |
| Exercise | 4-5x per week muscle activation (strength and VO2max training) |
| Sleep and stress | Attention to recovery |
| Supplements | Keep vitamin D and magnesium at level |
When medication is and is not useful
Section titled “When medication is and is not useful”| CCS | Risk profile | Advice |
|---|---|---|
| 0 | No risk | No medication; repeat in 5 years |
| 1-99 | Slight residual activity | Sharpen lifestyle; check in 3 years |
| 100-399 | Metabolically active | Consider LDL lowering with high ApoB or CRP |
| ≥400 | Metabolically active | Medication for progression or inflammation |
| ≥400 | Metabolically calm | No medication; continue lifestyle; check in 3-5 years |
Biochemical monitoring
Section titled “Biochemical monitoring”Annual evaluation of:
| Parameter | Target value |
|---|---|
| CRP | Below 1 mg/L |
| ApoB | Below 0.8 mmol/L |
| TG/HDL ratio | Below 1 |
| Fasting insulin | Below 7 µU/ml |
| CCS progression | Not above 20%/year |
Aspirin: yes or no?
Section titled “Aspirin: yes or no?”Aspirin (acetylsalicylic acid) inhibits COX-1 in platelets and lowers clotting tendency.
| Context | Advice |
|---|---|
| Primary prevention | Limited benefit, real bleeding risk |
Consider low dose (≤100 mg/day) only for:
Section titled “Consider low dose (≤100 mg/day) only for:”| Criterion | Details |
|---|---|
| CCS ≥400 | And active metabolic unrest (CRP↑, ApoB↑, CCS progression) |
| Low bleeding risk | And good stomach protection |
Summary
Section titled “Summary”Veelgestelde vragen
What is the calcium score?
The coronary calcium score (CCS) measures calcifications in the coronary arteries. A higher score means that in the past there has been inflammation and vessel wall damage. Calcium is the scar of healing, not necessarily a sign of active disease.
What does my calcium score mean?
CCS 0 = no indication of atherosclerosis, CCS 1-99 = beginning calcification, CCS 100-399 = clear atherosclerosis, CCS ≥400 = extensive calcification with usually stable plaques. The score shows atherosclerosis but says nothing about the activity of the process.
When is medication needed with high calcium score?
For CCS ≥400 with metabolic unrest (elevated CRP, ApoB, CCS progression), medication may be needed. With metabolic rest and healthy lifestyle, medication is often not needed, but monitoring remains essential. Lifestyle always remains the foundation.
Should I use aspirin?
Only consider for CCS ≥400 and active metabolic unrest (elevated CRP, ApoB, CCS progression), low bleeding risk and good stomach protection. Avoid aspirin with metabolic rest, absence of symptoms or increased bleeding risk.
Medische Disclaimer: De informatie van Stichting Je Leefstijl Als Medicijn over leefstijl, ziektes en stoornissen mag niet worden opgevat als medisch advies. In geen geval adviseren wij mensen om hun bestaande behandeling te veranderen. We raden mensen met chronische aandoeningen aan om zich over hun behandeling goed door bevoegde medische professionals te laten adviseren.
Medical Disclaimer: The information provided by Stichting Je Leefstijl Als Medicijn regarding lifestyle, diseases, and disorders should not be construed as medical advice. Under no circumstances do we advise people to alter their existing treatment. We recommend that people with chronic conditions seek advice regarding their treatment from qualified medical professionals.