Calcium Score Percentile Chart: MESA Reference Data by Age, Sex, and Ethnicity

Updated April 2026 · 16 min read

This page provides the most comprehensive publicly available reference tables for coronary artery calcium (CAC) score percentiles. All data comes from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort of 6,814 participants free of clinical cardiovascular disease, aged 45-84, across four race/ethnicity groups. The original MESA CAC Reference Values are published by McClelland et al. (Circulation, 2006) and remain the clinical standard cited in the 2026 ACC/AHA Guidelines on Dyslipidemia.

Your absolute CAC score tells you how much calcified plaque is in your coronary arteries. Your percentile tells you how that score compares to others of the same age, sex, and ethnicity who were free of cardiovascular disease. Both pieces of information matter clinically.

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How to Read These Tables

Each table below shows the estimated 25th, 50th, 75th, and 90th percentile CAC scores, plus the estimated probability of having any calcium at all (CAC > 0), for a given age, sex, and race/ethnicity. The tables use 5-year age increments from 45 to 84.

A CAC score above the 75th percentile for your age, sex, and ethnicity indicates a higher-than-expected plaque burden. The 2026 ACC/AHA Dyslipidemia Guideline recommends lipid-lowering therapy for adults with a CAC score of 100 or above, or above the 75th percentile for their demographic group, with an LDL-C target of less than 70 mg/dL.

White Males

Age	% With CAC > 0	25th	50th	75th	90th
45	25%	0	0	3	36
50	41%	0	0	18	103
55	56%	0	6	72	234
60	69%	0	32	174	476
65	79%	3	93	378	913
70	86%	21	179	631	1432
75	91%	63	310	1015	2184
80	95%	132	473	1408	3072

White Females

Age	% With CAC > 0	25th	50th	75th	90th
45	10%	0	0	0	2
50	18%	0	0	0	13
55	30%	0	0	3	55
60	43%	0	0	22	138
65	57%	0	6	76	299
70	68%	0	23	168	534
75	78%	0	66	320	874
80	85%	3	132	514	1325

Black Males

Age	% With CAC > 0	25th	50th	75th	90th
45	17%	0	0	0	10
50	28%	0	0	3	52
55	41%	0	0	22	146
60	54%	0	4	75	317
65	65%	0	25	184	588
70	74%	0	65	370	990
75	82%	2	145	639	1503
80	87%	14	253	957	2048

Black Females

Age	% With CAC > 0	50th	75th	90th
45	8%	0	0	1
50	15%	0	0	7
55	24%	0	1	31
60	36%	0	8	84
65	48%	0	38	183
70	59%	8	96	351
75	69%	27	197	590
80	77%	63	341	889

Hispanic Males

Age	% With CAC > 0	25th	50th	75th	90th
45	21%	0	0	1	18
50	34%	0	0	8	70
55	49%	0	0	41	189
60	62%	0	14	115	393
65	73%	0	52	262	719
70	81%	5	117	482	1126
75	87%	29	230	786	1615
80	92%	69	375	1132	2182

Hispanic Females

Age	% With CAC > 0	50th	75th	90th
45	6%	0	0	1
50	12%	0	0	5
55	21%	0	0	24
60	34%	0	6	71
65	47%	0	32	156
70	59%	7	84	306
75	70%	24	181	519
80	78%	58	320	782

Chinese Males

Age	% With CAC > 0	25th	50th	75th	90th
45	17%	0	0	0	9
50	26%	0	0	2	36
55	37%	0	0	13	86
60	48%	0	0	41	178
65	59%	0	7	99	334
70	68%	0	27	197	544
75	76%	0	63	341	855
80	82%	2	116	526	1197

Chinese Females

Age	% With CAC > 0	50th	75th	90th
45	4%	0	0	0
50	8%	0	0	2
55	15%	0	0	12
60	24%	0	1	40
65	35%	0	9	86
70	47%	0	33	166
75	57%	5	80	286
80	67%	18	149	452

Source: McClelland RL et al. "Distribution of Coronary Artery Calcium by Race, Gender, and Age." Circulation. 2006;113(1):30-37. MESA CAC Reference Values based on 6,814 participants free of clinical CVD and treated diabetes, ages 45-84. Values represent Agatston score estimates at given percentiles. These are the reference tables used by the MESA CAC Reference Values calculator (mesa-nhlbi.org) and cited in the 2026 ACC/AHA Guideline on Dyslipidemia.

Key Patterns in the Data

White Men Have the Highest Calcium Burden

At every age, White men have the highest CAC scores of any demographic group. By age 65, the 90th percentile for White men is 913, compared to 588 for Black men, 719 for Hispanic men, and 334 for Chinese men. By age 80, virtually all White men (95%) have some detectable calcium.

Women Lag Men by Roughly 10-15 Years

A 65-year-old White woman's 90th percentile score (299) is comparable to a 55-year-old White man's (234). This roughly 10-year gap is consistent with the well-established observation that women develop coronary atherosclerosis later than men, likely reflecting the protective effects of estrogen during premenopausal years.

Chinese Participants Have the Lowest Calcium Scores

Chinese men and women consistently have the lowest CAC scores at older ages. By ages 75-84, Chinese men have approximately one-third the calcium burden of White men at the same age. This does not necessarily mean lower cardiovascular risk overall, as plaque composition and non-calcified plaque may differ across ethnicities.

Absolute Score vs. Percentile: Why Both Matter

Research from MESA (Detrano et al., 2008) found that absolute CAC score categories (0, 1-100, 101-400, 400+) predict cardiovascular events better than age-sex-race percentiles. A score of 400+ carries high risk regardless of percentile. However, percentiles provide crucial clinical context: a score of 150 in a 50-year-old White male (above the 90th percentile) warrants a different conversation than the same score in a 75-year-old White male (below the 50th percentile). For a complete interpretation of your score, use the CT Calcium Score Calculator.

Clinical Implications: 2026 ACC/AHA Guideline

The 2026 ACC/AHA Guideline on the Management of Dyslipidemia incorporates CAC scoring as a key decision point for statin therapy. The guideline recommends initiating lipid-lowering therapy for adults with a CAC score of 100 or above, or above the 75th percentile for their age, sex, and ethnicity, with a treatment target of LDL-C below 70 mg/dL.

For patients with a CAC score of 0, the guideline supports deferring statin therapy for 5-10 years in most cases, as the "warranty period" of a zero score (the period during which risk remains very low) has been validated in multiple studies. The warranty period concept is explored in detail by Dzaye et al. (JACC Cardiovasc Imaging, 2021) and is integrated into the CT Calcium Score Calculator.

For the 10-year risk calculation that incorporates CAC along with traditional risk factors, see the MESA 10-Year CHD Risk Calculator. For a broader overview of what calcium scores mean, read our guide to calcium score interpretation or the MESA Risk Score explainer.

Interpret Your Calcium Score

Get your exact MESA percentile, risk category, warranty period, and clinical recommendations.

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Calcium Score Percentile FAQ

What does it mean to be above the 75th percentile?

Being above the 75th percentile means your calcium score is higher than 75% of people of the same age, sex, and ethnicity who were free of cardiovascular disease in the MESA study. The 2026 ACC/AHA Guideline uses the 75th percentile as a threshold for recommending intensified lipid-lowering therapy, as it indicates a greater-than-expected atherosclerotic plaque burden for your demographic group.

Should I use percentiles or absolute scores?

Both provide useful information. MESA research has shown that absolute score categories (0, 1-100, 101-400, 400+) are stronger predictors of cardiovascular events than percentiles alone. However, percentiles add important context. A "moderate" absolute score may be very high for a young person (above the 90th percentile) or very average for an older person (50th percentile). Most clinicians use both together to guide treatment decisions.

Do these percentiles apply to people under 45?

No. The MESA study enrolled participants ages 45-84. For adults aged 30-44, a separate reference dataset has been developed from the CARDIA study, the CAC Consortium, and the Walter Reed Cohort (Osborne et al., Eur Heart J, 2022). Any calcium detected in adults under 45 is considered clinically significant, as the prevalence of CAC is much lower in younger populations.

Are these numbers still accurate in 2026?

Yes. The MESA CAC percentile data is based on a cross-sectional cohort and has been validated in multiple external studies, including the Heinz Nixdorf Recall Study in Germany, which found remarkably similar percentile estimates. The MESA reference values remain the standard cited in the 2026 ACC/AHA guidelines. Population-level calcium distributions change very slowly over time, so these percentiles remain clinically valid.

What if my ethnicity is not listed here?

The MESA study included four racial/ethnic groups: White, Black, Hispanic, and Chinese. If your background does not align with one of these groups, the closest approximation is often used clinically (for example, South Asian patients are sometimes compared to the White reference). However, this is an acknowledged limitation. Your absolute CAC score and the standard risk categories (0, 1-100, 101-400, 400+) apply regardless of ethnicity and are the primary basis for clinical decisions.

References

McClelland RL, Chung H, Detrano R, Post W, Kronmal RA. Distribution of Coronary Artery Calcium by Race, Gender, and Age. Circulation. 2006;113(1):30-37.
Detrano R, Guerci AD, Carr JJ, et al. Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups. N Engl J Med. 2008;358(13):1336-1345.
Blaha MJ, Budoff MJ, Tota-Maharaj R, et al. Improving the CAC Score by Addition of Regional Measures of Calcium Distribution. JACC Cardiovasc Imaging. 2016;9(12):1407-1416.
Dzaye O, Dardari ZA, Cainzos-Achirica M, et al. Warranty Period of a Calcium Score of Zero: Comprehensive Analysis from MESA. JACC Cardiovasc Imaging. 2021;14:990-1002.
Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA Guideline on the Management of Dyslipidemia. Circulation. 2026;153:e00-e00.

Related Tools

Get your personalized percentile with the CT Calcium Score Calculator. Calculate your 10-year CHD risk with the MESA Risk Calculator. Interpret your bone density with the DXA Score Interpreter. Check your kidney function with the eGFR Calculator. And read our complete guide to calcium score interpretation.

Disclaimer: This article is for informational and educational purposes and is not medical advice. CAC percentile data is sourced from the MESA study (McClelland et al., Circulation 2006) and represents estimates for participants free of clinical CVD and treated diabetes. These reference values should be interpreted in the clinical context of each patient's full risk profile. Consult your cardiologist or primary care physician for personalized guidance based on your CAC results.

Age	% With CAC > 0	50th	75th	90th
45	8%	0	0	1
50	15%	0	0	7
55	24%	0	1	31
60	36%	0	8	84
65	48%	0	38	183
70	59%	8	96	351
75	69%	27	197	590
80	77%	63	341	889

Age	% With CAC > 0	50th	75th	90th
45	6%	0	0	1
50	12%	0	0	5
55	21%	0	0	24
60	34%	0	6	71
65	47%	0	32	156
70	59%	7	84	306
75	70%	24	181	519
80	78%	58	320	782

Age	% With CAC > 0	50th	75th	90th
45	4%	0	0	0
50	8%	0	0	2
55	15%	0	0	12
60	24%	0	1	40
65	35%	0	9	86
70	47%	0	33	166
75	57%	5	80	286
80	67%	18	149	452

Age	% With CAC > 0	50th	75th	90th
45	8%	0	0	1
50	15%	0	0	7
55	24%	0	1	31
60	36%	0	8	84
65	48%	0	38	183
70	59%	8	96	351
75	69%	27	197	590
80	77%	63	341	889

Age	% With CAC > 0	50th	75th	90th
45	6%	0	0	1
50	12%	0	0	5
55	21%	0	0	24
60	34%	0	6	71
65	47%	0	32	156
70	59%	7	84	306
75	70%	24	181	519
80	78%	58	320	782

Age	% With CAC > 0	50th	75th	90th
45	4%	0	0	0
50	8%	0	0	2
55	15%	0	0	12
60	24%	0	1	40
65	35%	0	9	86
70	47%	0	33	166
75	57%	5	80	286
80	67%	18	149	452

Age	% With CAC > 0	50th	75th	90th
45	8%	0	0	1
50	15%	0	0	7
55	24%	0	1	31
60	36%	0	8	84
65	48%	0	38	183
70	59%	8	96	351
75	69%	27	197	590
80	77%	63	341	889

Age	% With CAC > 0	50th	75th	90th
45	6%	0	0	1
50	12%	0	0	5
55	21%	0	0	24
60	34%	0	6	71
65	47%	0	32	156
70	59%	7	84	306
75	70%	24	181	519
80	78%	58	320	782

Age	% With CAC > 0	50th	75th	90th
45	4%	0	0	0
50	8%	0	0	2
55	15%	0	0	12
60	24%	0	1	40
65	35%	0	9	86
70	47%	0	33	166
75	57%	5	80	286
80	67%	18	149	452