heart attack

FDA strengthens warning that NSAIDs increase heart attack and stroke risk

Gregory Curfman, MD

Assistant Professor of Medicine

Former Editor-in-Chief, Harvard Health Publishing

Back in 2005, the FDA warned that taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen increased the risk of having a heart attack or stroke. Last week it took the unusual step of further strengthening this warning. This was done on the advice of an expert panel that reviewed new information about NSAIDs and their risks. Because NSAIDs are widely used, it’s important to be aware of downsides of taking an NSAID and to take steps to limit the risk. The new warnings point out that heart attack and stroke risk increase even with short-term use, and the risk may begin within a few weeks of starting to take an NSAID. The risk increases with higher doses of NSAIDs taken for longer periods of time. The risk is greatest for people who already have heart disease, though even people without heart disease may be at risk.

Big arm-to-arm difference in blood pressure linked to higher heart attack risk

The next time you have your blood pressure checked, ask your health care to check it in both arms, rather than just in one. Why? A big difference between the two readings can give you an early warning about increased risk of cardiovascular disease, a new study suggests. Harvard researchers found that people who have a 10-point difference in blood pressure from one arm to the other are 38% more likely to have a heart attack, stroke, or a related problem than those with arm-to arm differences less than 10 points. Small differences in blood pressure readings between the right and left arm are normal. But large ones suggest the presence of artery-clogging plaque in the vessel that supplies blood to the arm with higher blood pressure. Clogging there means there’s a good chance the arteries in the heart and brain are also clogged, boosting the odds of having a heart attack or stroke.

Heart attack chest pain is similar in women and men

Howard LeWine, M.D.

Chief Medical Editor, Harvard Health Publishing

In many ways, women are different from men. One way in which they are alike is how they “feel” a heart attack: with similar kinds of chest pain. Other heart attack symptoms may differ, but chest pain is pretty standard, according to European study of nearly 2,500 men and women. Few differences in chest pain were seen between the sexes. What’s more, the kind or duration of chest pain didn’t help tell a heart attack from some other problem. The conclusion? A careful medical history, an electrocardiogram, and blood tests are the best way to diagnose a heart attack in men and women. During a heart attack, more than three-quarters of men and women experience chest pain or discomfort. In the run-up to a heart attack, chest pain with exertion is a more common warning sign in men, while women often have other types of symptoms, such as fatigue and disturbed sleep.

Women often fear sex after a heart attack

A heart attack can be a frightening wake-up call with long-lasting aftereffects. It’s no surprise that women often tread gently after having a heart attack—and many don’t tread back into the bedroom for sex. Up to 60% of women are less sexually active after a heart attack, often due to worries that sex could trigger a repeat heart attack. A new study suggests that although women believe sex is important for resuming a sense of normalcy and intimacy with their partners, many are fearful that it would be too much for their hearts to take. Reassurance from a doctor is sometimes all that’s needed to ease those fears. How does a woman know if she’s physically ready for sex after a heart attack? It’s safe to have sex if you can work up a light sweat without triggering symptoms like chest pain or shortness of breath.