Jonathan Vafai, MD, FACC, FASE

12/07/2025

Statins: Safe, Powerful, and Life-Saving

The foundation of heart health is always a healthy lifestyle: regular exercise, smart nutrition, weight management, good sleep, and not smoking. These habits are essential, powerful, and non-negotiable. That said, for many patients, lifestyle alone is not enough to overcome genetics and long-term cardiovascular risk. This is where medications like statins become life-saving.

Statins are among the most thoroughly studied and effective medications in all of modern medicine. They don’t just lower LDL (“bad”) cholesterol - they significantly reduce the risk of heart attack, stroke, and cardiovascular death. I see these benefits every day in my own patients.

Like all medications, statins can have side effects. The reality is that most patients tolerate them extremely well, and when side effects do occur, they are usually mild, manageable, and reversible. For patients who truly cannot tolerate a statin, we now have excellent non-statin alternatives, including:
✅ Ezetimibe (Zetia)
✅ PCSK9 inhibitors (eg: Repatha, Praluent)
✅ Inclisiran (Leqvio)
✅ Bempedoic acid (Nexletol)
✅ Combination therapies

Another common fear I hear is about memory loss or dementia. The medical evidence is very reassuring:
🧠 Statins do not cause dementia
🧠 In fact, multiple large studies suggest statins may be protective against vascular dementia and stroke-related cognitive decline

One of the greatest threats to heart health today is not statin side effects - it is rejection of proven, life-saving therapy due to fear and misinformation. Untreated high cholesterol quietly fuels plaque buildup for years before a heart attack or stroke ever happens.

The solution is not avoiding medication. The solution is personalized, physician-guided care, built on lifestyle first and supported by the right therapy when needed.

If you have stopped a statin, are afraid to start one, or had side effects in the past - don’t give up on cholesterol treatment. There is almost always a safe and effective path forward.

Prevention works. Your heart health matters.

11/01/2025

Exercise: The Most Powerful Prescription for Your Heart ❤️

If there were a pill that could lower your blood pressure, improve your cholesterol, reduce stress, strengthen your heart, boost your mood, and help you live longer — everyone would want it.

That “pill” already exists. It’s called exercise.

Regular physical activity is one of the most effective, evidence-based ways to prevent heart disease and improve cardiovascular health. Just 30 minutes a day of moderate activity - like walking, biking, swimming, or even dancing - can make a lasting difference.

You don’t need a gym membership or fancy equipment. The key is consistency. Start small, move daily, and treat exercise like you would any other prescription - something you do for your long-term health.

Your heart doesn’t just need medication - it needs motion. ❤️

10/24/2025

We are again doing cutting edge work at Delray!

It's another medical milestone for Delray! ❤🎉👏 Today we completed our first TRICvalve implantation for tricuspid regurgitation - and we are one of only three sites in Florida to do the procedure. Congratulations to Tilak Pasala, MD, Medical Director of Structural Heart and his incredible team of clinicians!

TRICvalve implantation is a transcatheter procedure for treating severe tricuspid regurgitation (TR) by inserting two self-expanding bioprosthetic valves into the superior and inferior vena cava (SVC and IVC). This minimally invasive approach aims to prevent the backward flow of blood, which helps improve quality of life and right heart function without the high risks of open-heart surgery. The implantation can reduce congestion, improve cardiac output, and lead to significant improvements in symptoms and quality of life for high-risk patients.

For more information on Dr. Pasala, click here http://bit.ly/4oweS7P

10/21/2025

09/17/2025

We are not exactly in an underserved area but this is more support to exercise regularly!

Walking quickly for 15 minutes per day was associated with a significant reduction in all-cause mortality and CVD mortality, according to a cohort study published in American Journal of Preventive Medicine.

09/08/2025

A Hidden Heart Risk You May Not Have Heard Of: Lipoprotein(a)

Most individuals are familiar with "bad" cholesterol (LDL-c) and "good" cholesterol (HDL-c). However, there exists another crucial particle called Lipoprotein(a), or Lp(a), that many individuals are unaware of, and it may be a missing link in heart disease risk.

Why it matters
• Elevated Lp(a) levels increase the risk of heart attacks, strokes, and aortic valve disease, even if your LDL and HDL are within normal ranges.
• Lp(a) is primarily genetic, meaning lifestyle modifications such as diet and exercise will not lower it.
• If heart disease runs in your family, especially at a young age, testing for Lp(a) can be crucial.

What’s new in research
Currently, several large clinical trials are underway testing new medications that specifically target and lower Lp(a). These drugs have shown promise in early studies and could offer a new way to protect individuals who carry this hidden risk factor.

What you can do today
• Inquire about an Lp(a) test: It’s a simple blood test that can provide valuable insight into your heart risk.
• If you have high Lp(a), your doctor may recommend closer monitoring and more aggressive management of other risk factors (blood pressure, LDL cholesterol, diabetes).
• Stay informed, as treatments are on the horizon, and the next few years could be practice-changing.

Takeaway: Knowing your Lp(a) level is another powerful step toward personalized heart care.

08/30/2025

This is a nice list of considerations about coronary calcium scans. Many people are asking about it, I’m a fan of the test when used for the right reasons.

727 likes, 65 comments. “Ten Things Most People Don't Know About The Coronary Artery Calcium Heart Test.”

08/23/2025

Unhealthy weight has been linked to 60+ conditions, including heart risk factors, , & . Download the latest infographic supporting the ACC’s new Concise Clinical Guidance on medical weight management.

More in : https://bit.ly/3HKzd9Q

08/16/2025

Big news in heart health: the ACC and AHA just released updated guidelines for high blood pressure.

The new recommendations stress earlier treatment, protecting brain health, better kidney testing, and personalized risk tools to guide care. Lifestyle changes remain the foundation, but we now know that early and tailored treatment can make an even bigger difference in protecting your heart and brain.

If you have questions about what this means for you, let’s talk at your next visit.

Take a look at this easy summary from the American Heart Association:

There is stronger proof now that high blood pressure is linked to increased risk of cognitive.

08/09/2025

Thrilled to share that I, along with our team at South Florida Heart Institute – Palm Beach Health Network Physician Group, have been named among Castle Connolly Top Doctors Top Doctors 2025! An article with our photo is featured in this month’s Boca Raton Observer magazine.

I’m grateful to work alongside such talented and compassionate colleagues, and this recognition reflects the dedication we bring to providing the highest level of cardiovascular care every day.

Cardiovascular Disease

08/07/2025

The New York Times has published a compelling article on amyloidosis, a condition we're now detecting with increasing frequency and at earlier stages, offering new opportunities for intervention and hope.

A quiet revolution in care is helping patients with cardiac amyloidosis, a form of heart failure that long stumped doctors.