Heart Attack Archive

New studies shed light on the role of aspirin for people without a previous heart attack or stroke.

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It costs just pennies per pill, doesn't require a prescription, and may be lifesaving for some people. But daily low-dose aspirin doesn't make sense for everyone. Now, three major studies that examined the benefits and risks of this widely used drug may alter the advice about who should take aspirin.

"Aspirin remains a cornerstone of treatment after a heart attack or stroke. But the question of whether people with a low to moderate risk of heart disease should take aspirin is a really important one," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and professor of medicine at Harvard Medical School. Tens of millions of people in the United States fall into that low-to-moderate-risk category. But until now, there weren't many large trials that included those people, he notes.

Immediate first aid works to minimize blood clotting triggered by plaque ruptures

How should you take aspirin for a heart attack? You've always been healthy, but you seemed to run out of steam at your wife's 60th birthday dinner last week. And now your chest feels heavy, as if you're in a vise. You take some antacids, even though it's 7:00 a.m. and you haven't even had breakfast. But you get no relief, and the pain is spreading to your jaw and shoulder. You call your wife, who takes one look at you and rushes to the phone. After calling 911, she brings you an aspirin and some water.

Your wife got it right: You may be having a heart attack, and you need to get to the hospital fast. You also need to get some aspirin into your system quickly — but should you chew the tablet or swallow it?

Research we're watching

A new kind of drug given by injection can lower blood levels of lipoprotein(a), or Lp(a), a fatty particle linked to a heightened risk of heart attack and narrowing of the aortic valve, according to a study published January 1 in the New England Journal of Medicine.

Up to one in five people has a very high level of Lp(a), which is nearly completely determined by a person's genes. Lp(a) particles are similar to the better-known LDL cholesterol particles but with an extra protein coiled around each particle.

A regular sex life offers many heart health benefits. But can you stay sexually active with heart issues?

Regular sex is good medicine for your heart. But what if you've had a heart attack or a heart procedure? When is it safe to resume sex again — and should you?

"Most men can continue their sex life after a heart attack, unless there are additional circumstances that increase their risk," says Dr. Jason Matos, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center. "It depends on the person and his specific issue, but most men don't have to give up their sex life because of their heart health."

People monitor their cholesterol levels, but they should also watch their triglycerides.

Most people have heard of the two main kinds of cholesterol: the "good" HDL and the "bad" LDL. Doctors focus on controlling LDL, as high levels can lead to a buildup of fatty deposits in the arteries and block blood flow, which can trigger a heart attack or stroke.

A blood test called a lipid profile measures your HDL, LDL, and total cholesterol levels. But within that test is another number you should not ignore: your triglyceride levels.

Research we're watching

Late in 2019, the FDA approved a new use for icosapent ethyl (Vascepa), a drug that is a highly purified form of eicosapentaenoic acid (EPA), an omega-3 fatty acid found in fish.

The drug was originally approved in 2012 for treating people with very high levels of triglycerides, a type of fat in the blood. Now, icosapent ethyl is approved for people with triglyceride levels greater than or equal to 150 milligrams per deciliter who also have an elevated risk of cardiovascular disease despite taking the highest tolerable dose of a cholesterol-lowering statin. A large trial found that the drug decreases the risk of heart attack, stroke, and death from cardiac causes by 26% when compared with a placebo.

Research we're watching

Taking supplements that contain high levels of biotin (vitamin B₇) can lead to falsely low results on a blood test used to detect heart attacks, according to an FDA warning issued late last year.

For adults, the recommended dietary allowance (RDA) for biotin is 0.03 milligrams (mg), which is easily obtained through a healthy, varied diet. Many multivitamins and prenatal vitamins contain far more biotin than the RDA. And some supplements — particularly those marketed to improve hair, nails, and skin — contain 20 mg, or nearly 650 times the RDA.

Research we're watching

A drug long used to treat a painful form of arthritis called gout may also benefit heart attack survivors, according to a new study.

Derived from the autumn crocus, colchicine (Colcrys, Mitigare) helps to ease the joint inflammation and pain that characterize gout. Because mounting evidence suggests that inflammation plays a role in heart disease, researchers have tested various anti-inflammatory drugs in heart patients. The latest study, published online Nov. 16, 2019, by The New England Journal of Medicine, tested colchicine against a placebo in 4,745 people who had experienced a heart attack within the previous month. All the participants also took standard drugs to treat heart disease, including statins, aspirin, and other clot-preventing drugs.

Chronic stress is associated with an increased risk of heart disease, heart attacks, and strokes. These strategies can help you manage it.

People often complain about stress, but it's actually a natural reaction with an essential purpose.

When the body senses danger, it starts its fight-or-flight response. Your nervous system releases hormones like adrenaline and cortisol, which jolt the body into a protective mode. Your heart pounds faster, muscles tighten, blood pressure rises, breathing quickens, and your senses sharpen.

Taking these medications at bedtime rather than in the morning may make them more effective.

Many people take their medications as part of their morning ritual, along with a cup of coffee and the daily newspaper. But for blood pressure drugs, evening may be a better option. Last year, a large study found that taking blood pressure drugs before bed may lower the risk of serious heart-related complications more than taking the drugs in the morning (see "Benefits of bedtime blood pressure dosing").

The concept of chronotherapy, or adjusting medication dosing to a specific time of day, isn't new. There's not a great deal of evidence to support the practice with cardiovascular drugs, but it makes sense, says Dr. Naomi Fisher, director of the Hypertension Specialty Clinic at Harvard-affiliated Brigham and Women's Hospital.