Verdict
Not enough evidence
A zero calcium score does not make high ApoB safe in people under 50.
2 sources: 1 positive, 1 partly
By Arun AgrahriLast reviewed
Short answer
Not for a younger person. CAC and ApoB answer different questions. CAC detects calcified plaque already present, and ApoB counts the particles that can build plaque over time. Peter Attia says a zero CAC score may reassure older adults, but it does not make high ApoB safe in someone under about 50. Set targets with your doctor.
Lowering ApoB lowers the risk of heart disease.
The verdict on ApoB overall. 2 sources: 2 positive
positive partly neutral negative Each researcher and each study counts once per claim, however often they come up.
A zero calcium score does not make high ApoB safe in people under 50.
2 sources: 1 positive, 1 partly. Fewer than 3 sources so far.
Researchers say
1 positive
Peter Attia, on The Dr. Hyman Show, at 1:04:47
Positive Video · Opinion
Open the tape at 1:04:47 →“I'm delighted that you don't have a calcium score at the age of 48 but that doesn't give you a clean bill of health”
Studies show
1 partly
1 paper we read
Other primary study, JAMA Netw Open, 2022, PMID 35147685
Partly Study
Read the paper on PubMed →Because 22.8% of patients with LDL-C levels of at least 190 mg/dL had detectable plaque despite having CAC scores of 0, the results should not be used to withhold long-term preventive therapy with statins, especially in younger individuals.
Peter Attia, on The Dr. Hyman Show, at 1:04:47 Video · positive · Opinion
“I'm delighted that you don't have a calcium score at the age of 48 but that doesn't give you a clean bill of health”
Other primary study, JAMA Netw Open, 2022, PMID 35147685 Study · partly
Because 22.8% of patients with LDL-C levels of at least 190 mg/dL had detectable plaque despite having CAC scores of 0, the results should not be used to withhold long-term preventive therapy with statins, especially in younger individuals.
A zero calcium score does not make high ApoB safe in people under 50.
Peter Attia, on The Dr. Hyman Show, at 1:04:47
Positive Video · Opinion
Open the tape at 1:04:47 →“I'm delighted that you don't have a calcium score at the age of 48 but that doesn't give you a clean bill of health”
Other primary study, JAMA Netw Open, 2022, PMID 35147685
Partly Study
Read the paper on PubMed →Because 22.8% of patients with LDL-C levels of at least 190 mg/dL had detectable plaque despite having CAC scores of 0, the results should not be used to withhold long-term preventive therapy with statins, especially in younger individuals.
Precis is not affiliated with or endorsed by YouTube or by any researcher, show or publisher we quote. We take no sponsorship, ad or affiliate money, and every verdict is our own review of what was said. How we stay independent
A zero calcium score does not make high ApoB safe in a younger person. A coronary artery calcium (CAC) scan and an ApoB test both speak to heart risk, but they measure different things. The CAC scan looks for calcified plaque that has already formed, a snapshot of the disease you have built up.
ApoB counts the plaque-building particles in your blood: LDL, VLDL and Lp(a). That number sits closer to the cause, so particle count gives the fuller picture of what drives risk over time.
Peter Attia, discussing when CAC is useful, says a zero score can reassure an older adult even alongside high ApoB. The absence of calcified plaque later in life carries real information. For a younger person it does not.
He uses roughly 50 as the dividing line. Below it, the standard 10-year risk window is too short to capture the years of particle exposure still ahead. In that group he calls a positive CAC a "four-alarm fire".
A zero CAC is reassuring about today, not the decades after.
Mark Hyman, on his own show, cites the Western Denmark Heart Registry study. In its symptomatic patients, high LDL was linked to heart events only when the calcium score was high; with a zero score, high LDL showed no link. That study measured LDL rather than ApoB, but it is the strongest point on the record for trusting a clean scan.
Measure ApoB even when the calcium scan comes back clean, and read the two together. Your ApoB target, how to read a CAC result and whether to change anything are your physician's calls. This page reports what was said on tape and is not medical advice.
Precis membership
The answer above is the whole answer: the verdict, every counted mention, where the sources disagree, and the receipt behind each one. Nothing on this page is held back.
A free account adds
Pro adds
Full ApoB evidence report
The verdict on every claim, and where the sources disagree