Heart Attack Archive

Ask the doctors

Q. My partner recently had a heart attack. The doctor recommended exercise, but I wonder if it's better to take it easy. I feel like exercise might be dangerous or even cause another heart attack. Is exercising too risky?

A. As counterintuitive as it might seem, exercise is good medicine for heart attack survivors. Provided the doctor gives the green light, about two-and-a-half hours of moderate-intensity exercise each week can be beneficial — this is the amount recommended by the American Heart Association. Exercise can start as soon as the doctor gives the okay.

A "type 2" heart attack caused by severely restricted blood flow can be just as serious as a heart attack caused by a sudden complete blockage.

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In TV shows and movies, a man having a heart attack typically clutches his chest and falls to the ground, but most heart attacks are not nearly as dramatic.

"No two heart attacks are the same, nor do they strike in similar fashion," says Dr. Krishna Aragam, a cardiologist with Harvard-affiliated Massachusetts General Hospital. "Some heart attacks are subtler in their warnings, but can be just as serious and even deadly if they are not attended to."

Research we're watching

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A tendon that stretches between your heel and your calf may tell you something about your cardiovascular health. Researchers found that people with thicker Achilles tendons have more significant coronary artery disease and are at higher risk for a heart attack than those with thinner tendons.

The study, which was presented in November 2018 at the American Heart Association's Scientific Sessions meeting in Chicago, found that people with thicker Achilles tendons were more likely to have a blocked heart artery and left main coronary artery disease, which is associated with a high risk of heart disease and death. It's unclear, however, exactly why this artery was thicker in these individuals.

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Research we're watching

For years, many have speculated that taking vitamin D and omega-3 fatty acid supplements might help to prevent heart attacks, strokes, and certain cancers. But a study by Harvard researchers published online November 10, 2018, by The New England Journal of Medicine has found that the benefits may be more limited than originally hoped.

The results of the Vitamin D and Omega-3 Trial (VITAL), which enrolled more than 25,000 people and ran for more than five years, showed that while omega-3 supplements did appear to reduce the risk of heart attack, particularly among African Americans, they did not appear to be effective in preventing stroke or cancer. Vitamin D supplements also saw few benefits when it came to preventing heart attack, stroke, or cancer — but they were associated with a drop in cancer deaths in people who had taken the supplements for at least a year or two.

Research we're watching

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Electronic cigarettes, which are battery-operated devices that create a nicotine-filled vapor, are often touted as a less-risky alternative to conventional cigarettes. But daily e-cigarette use may nearly double a person's risk of a heart attack, according to a study in the October 2018 American Journal of Preventive Medicine.

The data came from nearly 70,000 people who took part in two National Health Interview Surveys. Compared with nonsmokers, people who smoked regular cigarettes daily nearly tripled their heart attack risk, compared with a nearly doubled risk among people who used only e-cigarettes. However, about two-thirds of current e-cigarette users also smoked regular cigarettes. Using both products daily was linked to a nearly fivefold increase in heart attack risk.

But use is primarily a concern for people who take them over a long period or who have certain health risks.

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Numerous studies in recent years have raised concerns that common pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of cardiovascular problems, such as heart attack and stroke.

A study published September 4 in The BMJ seems to confirm the risks associated with NSAIDs and notes that one medication in particular — diclofenac (Voltaren) — is associated with even higher risks to cardiovascular health than others in the same category.

Research we're watching

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Taking a low-dose aspirin every day could bring more risks than health benefits to healthy older adults, according to three papers from a single study, published online September 16 by The New England Journal of Medicine. The study, which began in 2010, included more than 19,000 adults ages 65 and older in the United States and Australia, who were free of cardiovascular disease, dementia, or disability, and followed participants for 4.7 years on average. Researchers found that treatment with a daily low-dose aspirin did not prevent dementia or disability. And rates of cardiovascular events (such as heart attacks and stroke) were similar between participants who took low-dose aspirin therapy and the comparison group that did not. While health outcomes were largely the same, people in the aspirin group were more likely than those who were not taking daily aspirin to experience significant bleeding, both in the gastrointestinal tract and the brain — a known risk of aspirin therapy.

While low-dose aspirin does not appear to benefit healthy older adults, this does not apply to people with known cardiovascular disease. For them, aspirin therapy significantly decreases risk of heart attack and stroke.

Ask the doctor

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Q. Is there something stronger than aspirin I can take for peripheral artery disease in my legs?

A. People with peripheral artery disease (PAD) in the legs have blockages (plaques of atherosclerosis) in the arteries that impair the flow of blood. Based on large scientific studies involving over 5,000 people with PAD, authorities recommend taking a daily aspirin tablet. For people with PAD, smoking cessation, regular exercise, and often other medicines such as statins, can help prevent further plaque buildup and decrease symptoms.

Common mental health disorders are linked to a higher risk of heart attack and stroke. Learn to spot the warning signs.

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Heart disease and mental health issues are both common. So it's not surprising that these problems often occur together. But are people with depression or anxiety more prone to developing cardiovascular disease?

Teasing out the answer to that question has proved tricky. Some factors known to contribute to a higher risk of heart disease (for example, an unhealthy diet, lack of exercise, and smoking) are also common in people with mental health issues. Now, new research that adjusts for those potentially confounding factors suggests the answer is yes.

Ask the doctor

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Q. The Harvard Health Letter has often said that it is generally healthy for women to have one alcoholic drink per day. Yet I hear a recent study showed no benefit. What's the truth?

A. Before answering your question, let's define "one drink": it's 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. And it means having one drink each day of the week, not having seven drinks on Saturday night, sleeping it off Sunday, and begging off until next Saturday night. Now, despite the recent study, we stick with what we've said, which reflects the research of outstanding nutrition scientists at Harvard and elsewhere.