From the Guidelines
To lower a high calcium score, it is essential to focus on comprehensive heart-healthy lifestyle changes and medication when appropriate, as evidenced by recent guidelines 1. The primary approach should involve adopting a Mediterranean or DASH diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting processed foods, saturated fats, and sodium.
- Exercise regularly with at least 150 minutes of moderate activity weekly.
- Quit smoking completely and limit alcohol to moderate levels (1 drink daily for women, 2 for men).
- Manage stress through techniques like meditation or yoga.
- Control related conditions like high blood pressure, diabetes, and high cholesterol through proper medication and lifestyle adjustments. Statins such as atorvastatin (20-80mg daily) or rosuvastatin (10-40mg daily) may be prescribed to lower LDL cholesterol and potentially slow calcium buildup, as supported by studies 1. Aspirin therapy (typically 81mg daily) might be recommended for some individuals. Regular follow-up with your doctor is essential to monitor progress and adjust treatment. These interventions work by reducing inflammation, improving cholesterol profiles, and stabilizing arterial plaques that contribute to calcium deposits in coronary arteries. While calcium scores cannot be reversed completely, these measures can significantly slow progression and reduce your overall cardiovascular risk, as noted in guidelines 1. It's also important to consider the role of calcium intake, particularly in patients with chronic kidney disease, where excessive calcium intake may worsen vascular calcification 1. However, for the general population aiming to lower a high calcium score, the focus should remain on heart-healthy lifestyle changes and evidence-based medical therapies.
From the Research
Lowering Calcium Score
To lower a high calcium score, several options can be considered:
- Medications: Cinacalcet has been shown to reduce serum calcium levels in patients with secondary hyperparathyroidism 2, inoperable parathyroid carcinoma 3, and hypercalcemia caused by pulmonary squamous cell carcinoma producing parathyroid hormone-related peptide 4.
- Pre-operative treatment: Administering Cinacalcet before total parathyroidectomy can reduce post-operative hypocalcemia in patients with severe renal hyperparathyroidism 5.
- Combination therapy: The use of a PCSK9 inhibitor and a statin has been found to lower the annual rate of coronary artery calcification compared to statin monotherapy 6.
Reducing Coronary Artery Calcification
To reduce coronary artery calcification, the following can be considered:
- Statin therapy: Statins can help reduce coronary atheroma and clinical events.
- PCSK9 inhibitor therapy: The addition of a PCSK9 inhibitor to statin therapy can lower the annual rate of coronary artery calcification.
- Combination therapy: The combination of a PCSK9 inhibitor and a statin may be more effective in reducing coronary artery calcification than statin monotherapy 6.