Heart Health Archive

Q. I've read that if you take aspirin every day, stopping it temporarily increases your chance of having a heart attack even higher than it would have been if you had never taken aspirin. Is that true? If I need to stop taking aspirin for some reason, is there a safer way to do it than stopping cold turkey?

A. What you are describing is sometimes called the rebound effect or rebound phenomenon. It occurs when a person stops taking a medication and the symptoms or problem that the medication had controlled reappear, but more severely than before the person started taking the medication. Although a rebound effect has been seen with some beta blockers and some sedatives used to treat insomnia, it is unlikely this happens with aspirin.

Q. When a friend of mine had a stress test, his doctor gave him a medication to make his heart work harder, instead of having him run on a treadmill. Does that mean medications could replace exercise to strengthen the heart?

A. When a person can't or shouldn't exercise, doctors use medications instead of a treadmill to conduct a stress test. Some of these medicines (such as dobutamine) make heart muscles work harder; others (such as adenosine) widen the coronary arteries.

Physical activity confers important health benefits, reducing the risk for many chronic conditions, including heart disease. Federal guidelines recommend that we get at least 150 minutes (2.5 hours) of moderately intense physical activity such as brisk walking each week, with greater benefits if we do even more. But even 2.5 hours a week is too much for some people, including those who are strapped for time. They'll be glad to hear that, according to a study, you can significantly lower your risk for heart disease by getting as little as 15 minutes of exercise most days of the week.

The study, led by researchers at Harvard School of Public Health, is the first to quantify just how much exercise is needed to reduce the risk of heart disease. It found, as expected, that you can lower the risk more by exercising longer. Interestingly, the effect was stronger for women than for men. Results were published in Circulation: Journal of the American Heart Association (Aug. 16, 2011).

Heart disease, stroke, diabetes, asthma, osteoporosis and other common chronic diseases are often blamed on genes, pollution, or the wear and tear caused by personal choices like a poor diet, smoking, or too little exercise. An intriguing hypothesis is that these and other conditions stem from a developing baby’s environment, mainly the womb and the placenta. During the first thousand days of development, from conception to age 2, the body’s tissues, organs, and systems are exquisitely sensitive to conditions in their environment during various windows of time. A lack of nutrients or an overabundance of them during these windows, so the thinking goes, programs a child’s development and sets the stage for health or disease.

Atrial fibrillation can be dangerous from a fast heart rate and a higher stroke risk

Is atrial fibrillation serious? People who are old enough to remember the sound of wind-up clocks often refer to their hearts as their "tickers." It's an affectionate term that pays tribute to the regular, rhythmic beat of the healthy heart. In fact, though, the healthy heart is much more sophisticated than the most precise Swiss timepiece.

Instead of maintaining a single, monotonous beat, the heart can speed up in response to exercise, strong emotions, and fever. Common chemicals can also jack up the heart rate; examples include caffeine, nicotine, and decongestants. And the healthy heart can also slow down when you rest, relax, or sleep.

Paying attention to changes in your body can help prevent a recurrence of heart failure.

People with pacemakers and implantable cardioverter-defibrillators (ICDs) are often told that they can’t get an MRI scan. The worry is that the powerful magnetic fields and radio waves MRI scanners use might “fry” the devices, induce current so hearts would beat wildly or, in the case of ICDs, cause an unnecessary shock. A new study suggests that with the proper monitoring, MRIs can be safe for many people with pacemakers and ICDs. One of the biggest obstacles will be cost, since a specially trained nurse or a doctor would need to be present to reprogram the device and to respond in case of an emergency.

Studies showing that alcohol protects the heart raise questions about drinking.

Does moderate, prudent drinking protect the heart and arteries? Two analyses say — shout, actually — that the answer is yes. But they raise a bigger issue: What should we do with this information? The answer to that question may come as a surprise.

Atrial ablation, also called percutaneous pulmonary vein isolation for atrial fibrillation, is a medical procedure that uses small bursts of electricity to stop patches of heart tissue from sending out "beat now" signals that cause the upper chambers of the heart to beat fast and wildly. As part of its Diagnostic and Therapeutic Cardiovascular Procedures section, the journal Circulation has posted a video of the procedure. This particular atrial ablation was done by Drs. Gregory F. Michaud and Roy John, of Harvard-affiliated Brigham and Women's Hospital.

Several screening tests have been developed to assess whether a person might have a drinking problem. Among these are the CAGE and AUDIT tests, as well as a questionnaire from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

If either of these test results suggests that you have an alcohol problem, contact your doctor, a psychotherapist, a substance abuse rehabilitation program, or a self-help group.