Coronary atherosclerosis can develop gradually for many years without causing symptoms.
This is why detecting it before a heart attack or other cardiovascular event occurs can be important for prevention.
During a CT scan of the coronary arteries — the blood vessels that supply the heart — calcium within atherosclerotic plaque can be detected and measured. The result is called a coronary calcium score, or CAC score.
If coronary calcium is found, it provides evidence that atherosclerosis is already present in the arteries of the heart, even if a person feels completely well.
Why does knowing this matter?
Because finding coronary atherosclerosis can provide additional information about a person’s cardiovascular risk. It can help doctors decide how closely risk factors such as cholesterol, blood pressure, smoking and diabetes should be assessed and managed.
A large study published in 2025 followed more than 66 000 adults without cardiovascular symptoms for a median of 12.5 years. People with higher coronary calcium scores had progressively higher long-term heart failure-related mortality.
The study does not show that coronary calcium itself causes heart failure. It also does not prove that everyone should undergo coronary calcium testing.
What it does show is that the amount of coronary calcium can provide important information about long-term cardiovascular risk.
For selected patients, detecting coronary atherosclerosis before symptoms develop may create an opportunity for earlier and more individualized prevention.
This is one of the central goals of cardiovascular longevity: not simply responding to cardiovascular disease after it becomes symptomatic, but identifying risk and disease earlier, when there may still be time to act.
