You got a zero on your calcium score, and now you want to know when to come back. The official answer is every 3 to 7 years. Your estimated 10-year risk for heart disease determines what percentage of this time frame you fall into. This is calculated by your physician based on your age, cholesterol level, blood pressure, whether or not you have diabetes, if you smoke and/or take medication for high blood pressure.
A first score above zero follows different rules. The National Lipid Association considers a repeat in 3 to 5 years reasonable when the new number could change your treatment.
Take Dana, a hypothetical 52-year-old whose first score was zero. Her doctor’s calculator puts her 10-year risk at 6 percent. Under National Lipid Association guidance, her next heart scan is due in 3 to 5 years.
In my judgment, a yearly calcium scan after a zero is money you don’t need to spend. None of the sources I cite recommend it, and a scan every year would mostly confirm the zero you already have.
In short, a first-time score of zero generally means you can wait several years before a repeat scan. But if you’re above a zero, have a talk with your doctor about how often your heart should be re-scanned.
When to Get a Heart CT Scan Calcium Score, and How Often
A National Lipid Association expert panel, with Carl E. Orringer as first author, set repeat intervals in a 2021 scientific statement on coronary calcium scoring. Cleveland Clinic’s authors give one figure in their patient guide to calcium scoring, every three to five years. They write that the test helps people whose risk falls between clearly low and clearly high.
| First Score | Your Situation | Published Repeat Interval | Source |
|---|---|---|---|
| 0 | 10-year risk under 5 percent | 5 to 7 years | NLA 2021 |
| 0 | 10-year risk of 5 to 19.9 percent | 3 to 5 years | NLA 2021. Cleveland Clinic gives 3 to 5 years for any normal first result |
| 0 | Diabetes, or 10-year risk of 20 percent or higher | 3 years | NLA 2021 |
| 1 to 99 | Any risk level | 3 to 5 years, when the result could change treatment | NLA 2021 |
| 100 or higher | LDL cholesterol still 70 mg/dL or higher | 3 years, to check for growth above 20 to 25 percent a year or a score increase past 300 | NLA 2021 |
This table summarizes general ACC/AHA screening guidance and the cardiology research cited throughout this article. It’s not a personalized recommendation. Your own timing depends on your full health picture, so talk with your doctor or one of our board-certified radiologists before scheduling.
To determine whether you should get a coronary artery calcium (CAC) scan, your doctor will look up your calculated 10-year cardiovascular disease risk using either the Pooled Cohort Equations, the older method the National Lipid Association (NLA) has recommended since 2013, or the newer PREVENT equations, which were adopted by the American College of Cardiology and the American Heart Association in their updated guidelines issued in March 2026.
The definitions of each are as follows:
| Risk Category | Risk Percentage |
|---|---|
| Low Risk | Less than 3% |
| Borderline | 3-4.99% |
| Intermediate Risk | 5-9.99% |
| High Risk | 10% or greater |
For scores above zero, The NLA panel allows a repeat test for scores of 1 to 99 when the new number could change treatment. The panel also allows one for scores of 100 or higher when LDL is still 70 mg/dL or above. I definitely side with the NLA panel, as long as you and your doctor agree ahead of the scan on what you’d do differently with the new number.
Now, if you’re actively experiencing symptoms like chest pain, shortness of breath, lightheadedness/weakness, or have experienced other symptoms related to your heart; see a doctor right away. The CAC scan will only help identify new symptoms.
Can a Zero on Your CT Heart Screen Calcium Score Turn Positive?
My favorite research on this is by Omar Dzaye and his colleagues. In their 10-year study, they tracked a total of 3,116 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA), all of whom had their first calcium scans showing no calcium present.
They studied how long it took for them to have new calcium in their arteries. For women, it was anywhere from 6 to 7.4 years (depending on race and ethnicity). On the other hand, for men, it was roughly 3.5 to 6.7 years.
Our hypothetical 52-year-old Dana’s age places her in the middle range; therefore, she should receive another heart scan at either year four or five max. Which also happens to be the exact recommendations made by both the MESA researchers and the National Lipid Association (NLA) panel.
Some other interesting finds from MESA were that new calcium showed up before 55 percent of later coronary events. Also, people who developed it had three times the risk of those who stayed at zero. In the same group, 19 percent of all 10-year coronary events happened in people with a zero before a 3- to 5-year rescan would’ve taken place.
How Diabetes, Family History, and Smoking Change the Heart CT Scan Timing
Now, let’s say Dana is diagnosed with diabetes at 54. Her NLA interval drops to 3 years from her first scan when she was 52, so she’s due at 55.
In MESA, diabetes cut the time to new calcium for women from 6.9 years to 4.3 years, and for men from 4.8 years to 3.1. The researchers described the effects of family history and smoking as “small.” If Dana’s father had a heart attack at 50, her doctor should take that history into account in a statin decision.
Is a heart scan every three years worth while for a low-risk adult? If you’re concerned, and the tests put you at ease, go for it. And the data from MESA showed about 15 percent of people passed a score of 10 within 5 to 8 years, and 8 percent had passed 100 by year 10.
In my judgment, a low-risk adult with no new risk factors probably don’t have to put this on top of their to-do list. But if your repeat scan comes back above zero, compare it with typical results for people your age in the guide I published about coronary calcium scores by age.
So Is a Zero Calcium Score a Pass?
A zero score means no calcium was found in your heart’s arteries. You could still have plaque that hasn’t hardened, though. That’s why other risk factors, including cholesterol, blood pressure, and family history should be taken into consideration alongside this.
A calcium score of zero means your risk of a heart attack is very low over the next two to five years. A German study found that 921 people still had a zero score when they were scanned again about five years later. Only 2% experienced a major cardiovascular event over 10 years. A zero is the best score you can get, but even with a zero, your doctor may recommend another scan later down the road.
Already diagnosed with heart disease? Another calcium scan probably won’t help you understand how well your treatment is working. And if your first scan found calcium in your arteries, doctors generally don’t recommend repeating it.
What Does a Rising Calcium Score Mean?
A score above zero means calcified plaque is present in your coronary arteries. I’d say it’s time to chat with your doctor about cholesterol treatment, and in some cases a repeat CT heart scan to measure how fast the number rises.
| Your Result | What Cardiology Sources Generally Suggest |
|---|---|
| Zero (no calcium detected) | Many people can wait several years, often three to five, before a repeat scan adds meaningful value, per Cleveland Clinic and Duke Health. |
| Any score above zero | Timing becomes individual. |
A Rising Score Example
Take Rob, Dana’s husband, also hypothetical. His first score was 90, and he’s never taken a statin. Three years later, his repeat score is 180. His score grew about 26 percent a year, and the NLA panel defines accelerated progression as growth above 20 to 25 percent a year. Rob meets that definition, which gives his doctor a reason to discuss stronger cholesterol treatment.
If Rob had started at 130 and taken a statin the whole time, the same 180 would work out to about 11 percent a year, under the threshold. Part of that rise could come from the statin, since statins raise the calcium content of plaque.
How to Interpret a Higher Score
Which tells you more, the jump between scans or the second number? The second number. Researchers in the Heinz Nixdorf Recall study tested 10 formulas for measuring progression in 3,281 participants. Once their models included the five-year score and five-year risk factors, progression added no predictive value. People who started between 1 and 399 and crossed 400 by the second scan had nearly twice the coronary and total cardiovascular risk of those who stayed under 400.
A high score in someone without symptoms isn’t a reason for a stress test or a cardiac catheterization. The NLA panel recommends against those tests in that situation and classifies them as potentially harmful. You can match your number to each score range, from zero to 400 and above, in the guide I wrote on calcium score results.
Why Your Score Can Go Up on a Statin
A statin can raise your calcium score while it lowers your cholesterol. Rishi Puri and colleagues pooled ultrasound images taken from inside the coronary arteries of 3,495 patients in eight randomized trials, followed for 18 to 24 months. Plaque calcium rose in every group and rose more in patients taking statins. Calcium rose even in the high-intensity statin group, where plaque volume shrank.
The authors concluded that “independent of their plaque-regressive effects, statins promote coronary atheroma calcification.” They suggested the extra calcium may make plaque more stable. The Agatston score measures calcium only, so your report shows the higher total with no measure of plaque volume.
In my experience, a yearly scan to check on your statin makes the least sense of any repeat. Yearly scanning will mostly confirm that calcium went up, which it was going to do anyway.
The exception is a score of 100 or higher with LDL cholesterol still at 70 mg/dL or above. In that case, the NLA panel considers a three-year repeat reasonable to look for accelerated progression, which may lead to more intensive treatment.
What About Radiation With Repeat Heart Scans?
A calcium scoring CT exposes you to about 1 millisievert (mSv) of radiation on average. Carl Orringer and the NLA panel reported a range of 0.5 to 2 mSv in their 2021 scientific statement. The average dose is comparable to a mammogram, or about one-third to one-half of the natural background radiation you’d receive in a year.
Cleveland Clinic gives a higher comparison in its patient guide to calcium scoring, estimating about a year’s worth of natural radiation. Your actual dose depends on the scanner and its settings.
Cleveland Clinic’s medical reviewers describe the cancer risk as “very small,” although repeated CT scans are a greater concern for people under 40. They also advise against calcium scans during pregnancy. There’s no contrast dye involved, so you won’t need an IV or have to worry about a reaction to the dye.
For Dana, whose first score was zero and whose estimated 10-year risk was 6 percent, I’d be looking at year four or five for another discussion about scanning. I wouldn’t recommend paying for an annual CT when the result isn’t expected to change treatment.
When to Call Your Doctor Before Your Next Heart Scan
A lot can change between scans. If your appointment is still a few years away, I’d contact your doctor sooner when one of these applies.
- Your last calcium score was above zero, and you haven’t discussed cholesterol treatment or what should happen next.
- You’ve developed diabetes since your zero score. The NLA’s 2021 guidance used a three-year interval for this group. Diabetes may also warrant cholesterol medication now, without waiting for another scan.
- You found out that a parent or sibling has early heart disease. Time to run a risk re-assessment.
- An increase in your cholesterol or blood pressure since your last appointment. You may need a change in treatment before another scan.
- You’ve started taking a statin. Ask how your LDL cholesterol will be checked. A repeat calcium score generally won’t measure how well the medicine works.
- Your last zero score is more than five years old, and your health history has changed.
New chest pain or unusual shortness of breath needs medical assessment rather than a routine screening appointment. If you think you’re having a heart attack, call 911.
What a Repeat Heart Scan Looks Like at Craft Body Scan
A heart scan at Craft Body Scan costs $640, regardless of whether it’s your first or a repeat. You can schedule directly without a physician referral or insurance approval, and we accept HSA and FSA payment.
The scan itself takes under five minutes. You’ll lie on the CT table while the scanner takes images of your coronary arteries. There’s no contrast dye, injection, or fasting required.
Your first visit involves more time than the scan. You’ll spend about 90 minutes with a health consultant like me, going over your medical history and looking at a sample report. You’ll know what a calcium score looks like before you receive yours.
A board-certified radiologist reviews the images, and another provider checks the report for abnormalities. You’ll receive your results through the Craft Medical Records System dashboard, generally within 5 to 10 business days. If the team finds something urgent, they’ll contact you sooner.
| Single Heart Scan | |
|---|---|
| Coronary calcium score CT, one person | $640 |
| Couples Heart & Lung Scan (PROMOTIONAL PRICE – BOOK WHILE IT’S AVAILABLE) | |
|---|---|
| Heart and lung screening, two people | $149 |
If you and your partner are considering the promotion, check if the additional lung screening is appropriate for each of you. The package includes more imaging than a calcium scan alone.
HSA and FSA cards are accepted, although your plan administrator determines which expenses qualify. You can read more about payment options in our heart scan cost guide.
Repeat Heart Scan Questions
How often should you get a heart CT scan after a zero score?
For selected adults who haven’t started cholesterol medicine, 3 to 7 years is the interval in the 2026 ACC/AHA guideline.
The NLA’s 2021 panel offers more specific intervals based on the older 10-year risk categories. For adults below 5 percent risk, it suggests 5 to 7 years. For those between 5 and 19.9 percent, it suggests 3 to 5 years. Diabetes and higher risk call for a separate treatment discussion, since another scan may not change the need for medication.
How common is a zero calcium score?
About half of the 6,814 adults in the Multi-Ethnic Study of Atherosclerosis (MESA) had a calcium score of zero. All were between 45 and 84 years old, with no known cardiovascular disease when the study began. Zero scores were more common in younger adults and women.
Does a rising calcium score mean a heart attack is coming?
No. Higher calcium scores are associated with a greater risk of heart disease, but the scan can’t predict when someone will have a heart attack.
In the Heinz Nixdorf Recall study, the score on the second scan predicted risk better than the amount of change between scans. I’d pay more attention to the latest score and what your doctor recommends for cholesterol treatment than to the percentage increase alone.
Should I repeat the heart CT scan if I’m taking a statin?
Generally, no. Statins can increase the calcium content of plaque while reducing cardiovascular risk. Another calcium score won’t tell you how well the medicine is working.
The NLA panel included a narrow exception in 2021 for patients with scores of 100 or higher and LDL cholesterol of at least 70 mg/dL. However, the newer 2026 ACC/AHA guideline advises against repeat calcium testing after cholesterol-lowering medication begins.
Your LDL results are generally more useful for monitoring treatment.
Is radiation from repeat calcium scans a concern?
Each CT adds another radiation dose. One calcium scan averages about 1 mSv, although the actual amount varies by machine.
Cleveland Clinic’s reviewers consider the cancer risk from one scan very small. I’d still avoid repeat imaging that offers no useful information for treatment, especially in younger adults. Calcium scans shouldn’t be performed during pregnancy.
Does insurance cover a repeat calcium score test?
Some insurance plans cover coronary calcium scans, while others consider them elective screening. Check your specific policy before booking at a facility that bills insurance.
Craft Body Scan charges $640 for an individual heart scan on a private-pay basis. You can use an HSA or FSA card, subject to your plan’s eligibility rules.
I’ve never had a heart scan. Where should I start?
Start with your estimated 10-year cardiovascular risk and your cholesterol results. A first calcium scan may help if your doctor is uncertain about starting a statin.
The test is less useful when your risk is already clearly low or you already need cholesterol-lowering medication. I’d rather see you book your first scan for a specific medical reason than simply because you’ve reached a certain age.
Set Your Next Heart Scan Date
If you already have a calcium score, bring the report to your next appointment. I’d also bring your most recent LDL cholesterol result and your estimated 10-year risk, including which calculator produced it.
If you’ve never had a calcium scan, ask whether the result would affect your decision about cholesterol medication. You may find that you don’t need one yet.
Once you and your doctor agree that a heart scan would be useful, you can choose the Craft Body Scan location closest to you and schedule online.
