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Harvard Heart Letter: February 2011

Articles in this issue:

Acetaminophen may boost blood pressure

Caution, attention should accompany routine use of any pain medicine.

For people with cardiovascular disease who need relief from aches and pains, acetaminophen (Tylenol, generic) has long been touted as a safer alternative to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. A small but important Swiss trial warns that it may not be. This work doesn't mean you should ditch acetaminophen if it helps you, but does suggest you should give it the caution that it — and every medication — deserves.

The Swiss team set out to fill a surprising gap in medical knowledge: the effect of acetaminophen ...

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Magnesium helps the heart keep its mettle

Food, and maybe a multivitamin, should provide all the Mg you need.

Magnesium deficits have been linked with a long list of cardiovascular and other disorders: high blood pressure, heart rhythm problems such as atrial fibrillation, cholesterol-clogged coronary arteries, painful spasms of coronary arteries, sudden cardiac arrest, diabetes, osteoporosis, and more. But whether modestly low magnesium stores are the cause of these conditions or the result of them is up in the air.

The uncertainty about magnesium was played out in back-to-back issues of the American Heart Journal with seemingly contradictory reports from two of the premier long-term studies of ...

Protect your heart during dental work


Don't stop taking aspirin, Plavix, or any other antiplatelet before dental work without asking your cardiologist.

The physical, emotional, and psychological stresses of surgery create conditions inside arteries that sometimes lead to a heart attack or stroke. This has long been known for coronary artery bypass grafting, hip replacement, and other major operations. Now it appears that tooth extraction and other oral surgeries also temporarily — but slightly — increase the risk of a heart attack or stroke.

Researchers in England created a bit of a ruckus when they reported that people were 1.5 times as likely to have ...

Coping with shortness of breath

New guidelines suggest treatments for the shortness of breath that can accompany advanced heart failure.

One of the most distressing complications of advanced heart failure is the feeling that you can't get enough air. This shortness of breath — dyspnea (DISp-knee-uh) in medicalese — has been defined in the cool language of clinicians as "a subjective experience of breathing discomfort" and "an uncomfortable sensation or awareness of breathing." People who have chronic shortness of breath describe it as suffocating, smothering, and hungering for air.

Chronic shortness of breath affects millions of people. It also commonly accompanies conditions such as chronic ...

New drug offers warfarin alternative for atrial fibrillation

An immediate switch is right for some people, but not necessary for all.

A newly approved alternative to warfarin, a drug called dabigatran (sold under the brand name Pradaxa), fights stroke better than warfarin, with less bleeding into the brain, among people with atrial fibrillation. It could also make life a little bit easier for them.

For more than 60 years, warfarin (Coumadin, Jantoven, generic) has been the mainstay "blood thinner" used by millions of people with atrial fibrillation to lessen the chances of developing a harmful, or possibly fatal, blood clot. Warfarin is a good drug — it is ...

Heart Beat: Taking the myth (and, alas, some of the romance) out of chocolate and the heart

The approach of Valentine's Day each year brings the latest crop of "chocolate is good for your heart" articles. We would all like to believe that a sweet treat protects the heart and arteries. But that notion isn't completely supported by the evidence.

Some studies show a strong connection between eating chocolate and less heart disease. In a survey of nearly 5,000 American adults, those who said they ate chocolate five times a week were 40% less likely to have ever had a heart attack or to have needed an artery-opening procedure (Clinical Nutrition, December 2010). A similar trend was ...

In Brief

Brief updates on coughing as a side effect of a type of blood pressure medication, waist circumference as an indicator of longevity, and a possible correlation between multiple miscarriages and increased risk of heart attack.

Ask the doctor: Could a sudden gain in weight be caused by hot weather?

Q. At 80 years old, I am in relatively good health, aside from a recent diagnosis of high blood pressure. Taking a beta blocker and watching my salt has brought my blood pressure down into the normal range. During a period of extreme heat this summer, my ankles were more swollen than usual, and my weight jumped three pounds in just two days. Was that because of the heat, or did salt have something to do with it?

A. Congratulations on getting good control of your blood pressure with a medication and salt restriction. Most people require two or three ...

Ask the doctor: How much psyllium is needed to lower cholesterol?

What amount of psyllium should I take each day to lower cholesterol?

Ask the doctor: Could getting a pacemaker have damaged my vagus nerve?

I recently had a pacemaker implanted. While the process was going on, I felt a pulsation that I reported to the doctor. I still feel it seven months later. Other symptoms include low blood pressure, an increase in weight, and digestive changes. My primary care doctor thinks that my vagus nerve could have been damaged when the pacemaker was implanted. Is that possible?

Ask the doctor: Is it okay to have an MRI after getting a stent?

I needed angioplasty in 2007 and had a stent implanted during the procedure. Due to another health problem, my doctor now wants me to have an MRI. Could this cause any problem with the stent?

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