Heart Attack Archive

Can boosting testosterone levels improve your sex life?

The hormone testosterone plays a big part in men's health, but perhaps its most meaningful role is to fuel sex drive and performance.

Testosterone levels tend to decrease with age. They peak by early adulthood and then can drop by up to 1% per year beginning around age 40. Sometimes an abrupt fall occurs because of an injury or illness (such as an infection), chemotherapy or radiation treatment, or certain medications.

Here's what the numbers mean — and strategies to lower your cholesterol if it's too high.

For some women who've had normal cholesterol readings all their lives, that changes at menopause. "Going through menopause often results in lipid and cholesterol changes for the worse," says Dr. Samia Mora, an associate professor of medicine at Harvard Medical School and a specialist in cardiovascular medicine the Brigham and Women's Hospital. Drops in the female hormone, estrogen, are associated with a rise in total cholesterol levels due to higher amounts of low-density lipoprotein (LDL), the "bad" cholesterol, and another blood lipid (fat) known as triglyceride. Over time this can raise heart risks, which is a reason for concern, as cardiovascular disease is the No. 1 cause of death in postmenopausal women, says Dr. Mora.

"So, it's especially important to track the numbers in perimenopause and the early years after menopause, as LDL cholesterol and total cholesterol tend to increase," she says.

These are the most effective ways to protect yourself.

Here are some alarming statistics about heart attacks:

• Every 40 seconds, someone in the United States has a heart attack.
• Every year, about 805,000 Americans have heart attacks, 75% of which are first-time attacks.
• The average age of a first heart attack among men: 65.

However, the most troubling fact about heart attacks is that many people don't take steps to protect themselves, says Dr. Deepak L. Bhatt, executive director of interventional cardiovascular programs at Harvard-affiliated Brigham and Women's Hospital Heart & Vascular Center. "Reducing your risk of cardiovascular disease is the best way to guard against heart attacks," he says. "There are simple ways to do this, but unfortunately, many people still don't follow them as they should."

Here's a look at five ways you can protect yourself from cardiovascular disease, and thus possible heart attacks, and avoid being another statistic.

Heart attacks are responsible for most cases of cardiac arrest. Know the warning signs—and what to if you witness a cardiac arrest.

Recently, a Harvard Heart Letter reader sent us an email asking about sudden cardiac arrest. This much-feared event occurs when the heart abruptly and unexpectedly stops beating. Each year, nearly 380,000 people in the United States experience cardiac arrest, and only about 10% survive.

"What are the causes and contributing factors? Are there early symptoms before the arrest occurs? And can it occur in a seemingly healthy middle-aged person?" she asked. Sudden cardiac arrest remains challenging to both predict and prevent. But there are definitely ways to lower your risk — and things that everyone should know (see "Recognize and react to sudden cardiac arrest").

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.