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Q: What are the best ways to prevent heart disease?

A: Exercise and a healthy diet. These two components constitute the cornerstone of cardiovascular health. Being physically active is the single most important factor in the prevention of heart disease and stroke. The American Heart Association recommends 30 minutes of moderate – intensity aerobic activity 5 days per week (e.q. brisk walking). While this is optimal, any activity is better than none. Regarding diet, I would preference any recommendation with the caution of embarking on any formal diet. 95% of all diets fail after 1 year. Dietary lifestyle modification is a much more effective and enduring approach. The most compelling data support a plant-based diet and Mediterranean Style Diet. The latte consists of fruits, vegetables, fish and the preferential use of olive oil or flaxseed oil over other oils. It is low in refined sugar and carbohydrates, saturated fats and red meat. I have found “The Mediterranean Diet” to be not only the healthiest approach but also sustainable and enjoyable.


Q: What is the best way to screen for coronary disease?

A: Currently there are no evidence-based guidelines for the general population. We currently use risk factors to predict one’s risk and tailor risk reduction accordingly. Stress testing is indicated for symptomatic patients and in selective circumstances. Alternative approaches include coronary computed tomography angiogram (CTA) and coronary calcium scoring. These modalities can be very helpful in certain individuals who fall into an intermediate-risk category. What is most important is to have a close relationship with one’s physician and engage in a thorough discussion to tailor a comprehensive approach.


Q: Are there alternatives to medications to reduce one’s cholesterol?

A: Absolutely, while statins are the predominant pharmacologic approach, there are certainly effective non-pharmacologic strategies. Exercise and diet should be the first step for everyone. Plant sterols and stanols are substances that occur naturally, in small amounts, in many foods. They are available in concentrated forms which have been shown to reduce LDL (“Bad Cholesterol”) by 15%-20%. Increasing fiber intake to 5-10 grams per day can reduce LDL by 5%-10%. Certain nuts such as walnuts, almonds and hazelnuts can have similar effects. Lastly Omega-3 Fatty Acids (Fish Oil) can have a dramatic impact (up to 40%) on reducing triglycerides levels.


George Moutsatsos, M.D., FACC, has been serving patients in the realm of cardiac care for more than a decade in the New Castle County area. He graduated from Tufts University and received his medical degree from Jefferson Medical College. He completed his Internal Medicine residency and Cardiovascular Fellowship at Georgetown University Hospital and is the founder of Westover Cardiology, LLC. Prior to establishing Westover Cardiology, LLC, he practiced as a managing partner with Cardiology Consultants for ten years. During that period, he was the director of the EECP Program and the Non-Invasive Laboratory at St. Francis Hospital. During his extensive training, he pursued his research interest in atherosclerosis and the oxidation of LDL at The National Institutes of Health having authored numerous papers and abstracts. Dr. Moutsatsos was recently elected to The Board of Governors of The American College of Cardiology and is currently President-elect of The Delaware Chapter of The ACC.


Westover Cardiology
2700 Silverside Road, Suite 3A
Wilmington, DE 19810


Dr. George Moutsatsos, MD, of Westover Cardiology

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