Heart Health Archive

Ask the doctor

Q. I recently started taking low-dose aspirin, per my doctor's advice. But I heard that for some people, aspirin doesn't help prevent heart attacks. Is this true, and is there any way to find out if I'm one of those people?

A. The phenomenon you're referring to is sometimes called aspirin resistance. However, true aspirin resistance is very uncommon. There are tests for the problem, but I don't recommend them.

The net benefit of these popular supplements is very limited.

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Millions of Americans swallow an amber-colored capsule of fish oil each day, lured by its alleged health benefits. In the supplement aisle of most pharmacies, supermarkets, and big-box stores, the shelves are crowded with different brands of fish oil supplements (see "Fish oil: A brief history"). Many tout benefits for the heart. In fact, the label of one popular brand includes the phrase "May reduce coronary heart disease risk."

But those bold marketing claims haven't caught up with the latest science. Earlier this year, the American Heart Association (AHA) issued an updated advisory about fish oil supplements and their cardiovascular benefits. Their verdict: Fish oil supplements may slightly lower the risk of dying of heart failure or after a recent heart attack. But they do not prevent heart disease. (A separate AHA advisory about fish consumption is slated for release in 2018.)

Closing a gap inside the heart may help prevent a rare type of stroke from recurring.

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Most strokes occur when a clot blocks blood flow to part of the brain. Often, doctors can tell what caused the clot to form. But about a quarter of the time — especially in people younger than 60 — there is no obvious reason. These types of strokes are known as cryptogenic (meaning "of hidden origin").

One possible cause underlying a cryptogenic stroke is an opening in the wall that separates the heart's right and left upper chambers (atria). Known as a patent foramen ovale, or PFO, this flaplike opening is quite common. About one-quarter of all adults have a PFO (see "What is a patent foramen ovale?").

A novel anti-inflammatory drug may discourage repeat heart attacks.

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Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular disease. However, identifying a drug therapy that leverages this link has been more elusive. With the results of the recent Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), published in the Sept. 21, 2017, issue of The New England Journal of Medicine, it appears that the dots are finally beginning to connect.

"For the first time, we have an anti-inflammatory therapy that can reduce the chance that a person who has already had a heart attack will have a repeat occurrence," says Dr. Peter Libby, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. "This opens up a new field of treatment and offers hope to our patients." He is one of the co-authors of the study, which was led by his colleague and fellow Harvard Medical School professor Dr. Paul Ridker.

Screening for lung and breast cancer may reveal information about the health of your heart's arteries.

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Screening tests for two of the most common forms of cancer involve detailed x-ray images of the chest. Growing evidence suggests that these tests — chest computed tomography (CT) scans and mammograms — may also offer clues about a person's risk of heart disease.

"Both doctors and their patients should be aware that the low-dose CT scans used to find lung cancer can also detect plaque in the arteries of the heart," says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital. CT scans take a series of rapid-fire x-rays in seconds. Combined, the images allow doctors to "see" structures inside the body.

Research we're watching

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The ancient, mind-calming practice of meditation may have a role in reducing the risk of heart disease. So says a scientific statement from the American Heart Association in the Sept. 28, 2017, Journal of the American Heart Association.

Experts reviewed dozens of studies published over the past two decades. The results suggest that meditation may improve a host of factors linked to heart disease, including stress, anxiety, depression, poor sleep quality, and high blood pressure. It may also help people stop smoking. An added bonus: it's low-cost and poses no apparent risk.

Research we're watching

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Noshing on a handful of nuts on most days of the week has been linked to a lower risk of obesity and heart disease. New research may help explain why: walnuts appear to activate a brain region involved in appetite and impulse control.

For the study, nine people with obesity drank a smoothie that contained about 14 ground walnut halves or a placebo smoothie (identical in taste and calories) for five consecutive days. After a month on their regular diets, the participants returned for another five days, during which the placebo group drank walnut smoothies and vice versa. On day five of both periods, they underwent brain imaging tests while looking at pictures of desirable foods (such as burgers and cake), less desirable foods (vegetables), or neutral pictures of rocks and trees.

Your body depends on the mineral potassium for many bodily functions, including keeping control of the electrical balance of your heart, metabolizing carbohydrates, and building muscle.

Low potassium levels can cause muscle weakness and heartbeat irregularities. On the other hand, too much potassium can cause your heart to stop.

It may help prevent a heart attack or stroke, but it comes with the risk of bleeding.

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Maybe you've heard about people who take a low-dose aspirin each day to ward off heart problems. Since aspirin is a medicine you've probably used now and then without a problem, and since it is available without a prescription, you might consider trying a daily low-dose aspirin yourself. Don't do it. Unlike deciding to take a multivitamin, taking a daily aspirin isn't something you should decide to do on your own.

Aspirin therapy is typically prescribed to people who have atherosclerosis of the arteries of the heart or brain, or risk factors for such disease. Just who should take a daily aspirin, how much aspirin, and what type of aspirin are hotly debated issues, with clinical trials under way in search of answers. "Until those results are in, you should talk to your doctor before starting aspirin," says Dr. Deepak Bhatt, a cardiologist and the editor in chief of the Harvard Heart Letter.