Coronary Artery Calcium (CAC) Scan
Cheap, non-invasive, shows actual plaque. Once at 40 or earlier with family history.
What it does
Bloodwork estimates cardiovascular risk; a CAC scan shows whether atherosclerosis has actually started. Fast, low-cost, low-radiation. A zero score suggests low near-term risk; a non-zero score means plaque is already present — either way it meaningfully changes lipid-management urgency.
Atherosclerotic plaques calcify as they mature, producing radiographically detectable density on CT. The total calcium burden (Agatston score) correlates with overall plaque load.
What the evidence shows
Overall evidence strength: High certainty
Who it's for, who should skip
Anyone 40+ (earlier with family history) deciding how aggressive to be on lipids. Usually done once — the score progresses slowly, so serial testing rarely changes management within a few years.
Running it
Measuring it
Retest CAC score — Score 0 — repeat in 3–7 years. Score 1–99 — about 5 years. On a statin — repeat not recommended..
Stacking & alternatives
Access & cost
Prescription or clinician order — typically via imaging center / cardiology (low-radiation CT).
Last reviewed 27 August 2026.