Heart Attack Archive

Research we're watching

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Heart attack risk may rise within a week of taking daily high doses of certain over-the-counter pain relievers, according to a new study.

Previous research has linked the use of pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) to a heightened risk of heart attack. The new report, published in the May 9, 2017, issue of The BMJ, analyzed data from nearly half a million people, of whom about 61,000 had heart attacks.

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New research may help explain why diets rich in animal-based foods are linked to a higher risk of heart attack.

The average American diet contains about 300 milligrams per day of choline, a nutrient found in meat, eggs, and milk. Earlier research found that when gut bacteria feed on choline, they make a compound called TMA. In the liver, TMA is converted to TMAO — a compound closely tied to heart disease risk.

If so, be extra vigilant about measuring and managing your blood pressure and cholesterol.

Filling out those family history forms at the doctor's office can be tedious. But sometimes, the devil is in those details. Because heart disease is so common, many people check "yes" to the question about whether their father or mother had heart disease. But if your father had a heart attack at age 77, that's likely different than if his heart attack happened when he was only 44.

"If you have any family history of heart disease, that should serve as a keen reminder to pay attention to factors that can raise your risk of a heart attack, such as high cholesterol, high blood pressure, and diabetes," says Dr. Howard Sesso, an epidemiologist with the division of preventive medicine at Harvard-affiliated Brigham and Women's Hospital. But if a parent or sibling had a premature heart attack, that's an even stronger signal to be more proactive in monitoring and lowering your risk, he adds. A premature or early heart attack is one that occurs before age 55 in a man or before age 65 in a woman.

A high pain tolerance may account for some "silent" heart attacks. But failing to recognize atypical symptoms is a more likely explanation.

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Nearly half of people who have a heart attack don't realize it at the time. These so-called silent heart attacks are only diagnosed after the event, when a recording of the heart's electrical activity (an electrocardiogram, or ECG) or another test reveals evidence of damage to the heart.

What's behind this surprising phenomenon? One explanation may be a higher-than-average tolerance for pain, as a recent study suggests (see "Does a high pain tolerance mask heart attack symptoms?"). Other people mistake their symptoms as indigestion or muscle pain. Still others may feel pain, but in parts of their upper body other than the center of the chest.

In the journals

Low-dose aspirin therapy is standard treatment for people who have suffered a heart attack or stroke to protect them from a second one. But what about people who don't have cardiovascular disease, but do have specific risk factors, such as type 2 diabetes? A study published in the Feb. 14, 2017, Circulation found that low-dose aspirin therapy in fact did not lower this group's risk for heart attack or stroke.

The researchers recruited more than 2,500 people, ages 30 to 85, with type 2 diabetes and randomly assigned them to take either 81 mg or 100 mg of aspirin daily, or no aspirin, for three years. At the 10-year follow-up, they found that the aspirin therapy did not lower risk of either heart attack or stroke compared with taking no aspirin at all. The reason is not clear, but the researchers speculated that people with diabetes might not experience the expected anti-clotting action of aspirin.

Research we're watching

Implantable cardioverter-defibrillators (ICDs) are miniature electronic devices placed under the skin below the collarbone to sense and stop abnormal heart rhythms. A study in the Jan. 24, 2017, Journal of the American College of Cardiology provides new information about outcomes in older people who receive these lifesaving devices.

The study included 12,420 people with an average age of 75. All had survived a sudden cardiac arrest and received an ICD. Nearly four in five of the participants survived at least two years. During the two-year period, nearly 65% were hospitalized at some point. Many were admitted to skilled nursing facilities during the study, including about 32% of those ages 80 and older.

Cardiovascular disease in women isn't identical to that in men. Understanding the differences can help you prevent or minimize the effects of a heart attack.

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Cardiovascular disease is the leading killer of women, but women's heart disease hasn't captured the popular imagination the way men's has. Although you can probably recall a movie in which a man collapsed with a heart attack, you're unlikely to remember a similar scene starring a woman. That may be because women develop heart disease about 10 years later than men do. While men are most likely to have a first heart attack around age 65, a woman's first heart attack occurs at an average age of 71. Moreover, heart disease doesn't become the leading cause of death for women until age 85.

If heart disease comes to women so late in life, why should we be concerned about it when we're younger?

In a large United Kingdom study, regularly practicing racket sports, swimming, or aerobics significantly reduced the risk of dying over eight to 13 years. 

Ask the doctor

Q. Should I take aspirin if I think I'm having a heart attack, and what kind of aspirin should I take?

A. First, what symptoms indicate you might be having a heart attack? The main symptom is a squeezing, tight sensation in the middle of the chest that can travel up into the jaw and shoulders, and even down the left arm. Along with the pain you may begin to sweat and to feel weak, like you might pass out, and be short of breath. While other conditions besides a heart at-tack can cause similar symptoms, you need to take such symptoms very seriously. First, call 911.