> The CAC scan, which detects calcified plaque in the arteries, is recommended for adults with borderline or intermediate risk of coronary disease for whom the decision to start preventive therapy such as statin drugs remains uncertain.

That is such incredibly bad advice. DO NOT WAIT until a CAC tells you to start a statin. You know you need to start if your LDL is high right away.

My doctor referred me to get a self pay ($100 at the time) CAC 9 years ago. It was completely clear.

However last year I had a cardiac ultrasound and it showed calcification.

In reality the CAC caused a false sense of security. My LDL had been high the whole time and not managed with any intervention despite having been tested multiple times and showing high over that time. This was a failure by my doctors IMO. (No it’s not diet or weight related before people give advice).

I didn’t need a CAC to tell me everything was fine. I needed to be on a low dose of statin that whole time.

A clear CAC doesn’t mean you are safe. And a positive CAC is already too late and is not really telling you anything useful.

What people need to do is just watch your LDL regularly starting from any age (yes even some 20 year olds need to check this). Don’t wait to middle age. And no matter your age use whatever methods you prefer to get that down as low as possible. Think of it as cumulative exposure over time that matters.

(There are new oral PCKS9 inhibitors out now which is cool, but the reality is all the misinformation about statins has been bullshit, don’t be afraid of them.)