I have a very high calcium score. What next?

Yes, that is the correct link and it uses existing heart disease (positive Ca score) as one of the risk elements. Making the right changes in lifestyle can push risk way down. I spoke to my doctor yesterday at length and he was very supportive, wants me to stop worrying and that my risk of a cardiac event are very low considering my meds, diet, weight loss and working out daily. My mom started statin treatment at 40. I should've done the same, but just didn't know. What is done is done, all I can do is limit new plaque burden and enjoy life. It is hard to get it out of your mind completely, in fact, my doctor said he somewhat regretted having me take the test as the burden maybe outweighs the value of the information. I had plenty of risk factors already that were motivating me to change prior to the test results. There is a good argument to made for not putting this burden on asymptomatic patients. This article resonated with me, "The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk Assessment" Mandrola et al 2019 Am Fam Physician.

Yes, that is the correct link and it uses existing heart disease (positive Ca score) as one of the risk elements. Making the right changes in lifestyle can push risk way down. I spoke to my doctor yesterday at length and he was very supportive, wants me to stop worrying and that my risk of a cardiac event are very low considering my meds, diet, weight loss and working out daily. My mom started statin treatment at 40. I should've done the same, but just didn't know. What is done is done, all I can do is limit new plaque burden and enjoy life. It is hard to get it out of your mind completely, in fact, my doctor said he somewhat regretted having me take the test as the burden maybe outweighs the value of the information. I had plenty of risk factors already that were motivating me to change prior to the test results. There is a good argument to made for not putting this burden on asymptomatic patients. This article resonated with me, "The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk Assessment" Mandrola et al 2019 Am Fam Physician.

i have calcium score of 3600, 76 year old male, passed stress test,in decent shape. what
is next?

Statin, regular exercise, plant based diet (or Mediterranean), good sleep and stress management, keep blood pressure and inflammation in check and quit smoking, moderate alcohol use.

Thank you. I am doing most of that, except eat a lot of fish, some chicken, and once in a while red meat, no dairy or cheese. Also take a baby aspirin, although had to get off statin twice because of muscle aches, will go back on at 5mg rosuvastatin. While on statin cholesterol went from 214 to 161.

When I went on Crestor 10mg I had muscle cramps in my legs for about 8 weeks, my doctor told me to try to deal with it and ignore it and take a wait and see approach and eventually it went away, if it's tolerable try to wait it out a few months and see if it goes away.

I guess I've been lucky not having any problems being on 20mg of Crestor. You might ask your doctor about doing alternate day dosing (ADD). Some people find relief from that. I've read a few articles that stated your cholesterol levels take many weeks to go back to where they were before starting a statin, so doing ADD "shouldn't" have much impact in your cholesterol levels (but of course, check with your doc). And articles I've read stated that there's not a significant difference in cholesterol levels between groups doing ADD and groups doing EDD (every day dose). Might be worth discussing with your doc.