I have a very high calcium score. What next?

Uh ... my understanding - not a medical professional - is that cholesterol in most folks is affected by what you eat.
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192#:~:text=Saturated%2520fats%2520%E2%80%94%2520such%2520as%2520those,by%25208%2525%2520to%252010%2525.

Where can one find these to read?

I've heard that too, but aren't there numerous examples of people who lowered their cholesterol simply be eating better?

Given your family history, you might want the doctor to check your Lipoprotein a (Lp a) level along with homocysteine, C-Reactive Protein (CRP), and High Sensitivity CRP and . Lp a is very hereditary.

Options to consider for a better understanding:
- stress test with echo
- nuclear stress test
- advanced lipids panel (called CardioIQ by Quest labs)

Perhaps add Icosapent Ethyl (Vascepa) to you meds.

I’m an active healthy ( I thought) 70 year old female, exercise regularly, eat a healthy diet and not overweight, found out my CAC is 537. My family history is bad with heart disease, aneurysm and stroke on both parents side. I had a heart cath which did not require stenting yet, and my carotid ultrasound shows 69% blockage in left carotid artery, and doctor said they don’t clean out the carotids till 70% blocked when I asked if I could have it done. Yes I am freaked out by this, so I have endeavored to eat even healthier, more evoo, flax seed, and have lost a few pounds. My cardiologist put me on Crestor 40 mg daily, baby aspirin, a vasodilator and blood pressure meds. I rarely have high blood pressure but occasionally it would spike up so I’m glad to be on the meds. I sure would like to be proactive on this, any recomendations?

Have you checked PTH lab?
I had that high plus hypercalciumia of 10.5 or higher . I had a 2cm tumor adenoma removed on my parathyroid. Also had osteoporosis -3 as calcium not going into bones but bloodstream making one feel ill omus excruciating psin unsble to be upright more than 4 hours so had yo lie flat. Applied for SSDI but too hard to do.

2 weeks after removal my bone pain was gone as gland working again so dexa scan with wrist has improved some!

Plus have high MGUS labs so annual checks for multiple myeloma sent to Mayo!

My cardiologist has told me that yes, calcium regression is possible if you live to 150 as it's glacially slow, but low LDL along with a statin lowers the risk as you describe

Nothing can reverse calcification of the arteries except for some surgeries using artery sized blades or lasers that scrape it off and a catheter using sound waves which breaks it up, although I have read about some people having natural calcification regression with LDL levels below 60. The main thing you can do is take a statin to stabilize the plaque and harden up that gooey soft stuff which is what breaks off and causes all sorts of problems. Exercise/diet/low BP/low inflammation all help arterial health as well.

True. Mine is inherited and both of my kids have abnormal cholesterol levels, so it's not just diet. My diet is plant based, I'm at a good weight and exercise daily, and it still takes 3 drugs to get the cholesterol numbers down and to where I'm told over time, it will start to reverse what my body has done for the past 68 years. I've researched this for years: diet can lower your cholesterol numbers by around 20% at most. Your mileage may vary