Medical devices Archive

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Cardiologists expect wider use of the less-invasive technique—known as TAVR—in the near future.

The one-way valve inside your aorta opens to allow blood to surge from the heart to the rest of your body. But as you age, the valve's leaflets may stiffen and become clogged with calcium deposits, restricting blood flow. About 12% of people ages 75 or older have this condition, known as aortic stenosis. Symptoms include feeling dizzy, faint, tired, and breathless. Unless the valve is replaced, half of people with symptoms from aortic stenosis die within two years.

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Ask the doctor

Q. I would like to take generic drugs instead of brand-name drugs whenever possible, because they're cheaper. But are they really as effective?

A. First of all, generic drugs contain the exact same active ingredients as the brand-name versions. Second, in the United States, before approving a generic drug, the FDA must test it to be sure that the manufacturer has produced the same molecule, and that it achieves the same levels in the blood as the brand-name drug. Third, there have been many careful studies comparing generic drugs (once they have been approved) to their brand-name equivalents.

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Flibanserin is the first treatment of its kind. But it comes with a steep price tag and severe health risks.

It's now six months since the FDA approved flibanserin (Addyi), which is the first medication for sexual desire disorders. The drug was hailed as a "female Viagra," but is it living up to the hype? "It's not the solution we were hoping for," says Dr. Hope Ricciotti, editor in chief of Harvard Women's Health Watch and an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.

News Briefs

New guidelines from the American College of Physicians (ACP) urge doctors to prescribe generic medications whenever possible, rather than more expensive brand-name medications. The guidelines were published online Nov. 24, 2015, in Annals of Internal Medicine. An ACP committee, led by Harvard Medical School's Dr. Niteesh Choudhry, analyzed more than 2,500 studies and found that brand-name prescription medications are more likely to be prescribed, but not filled. The committee also observed that people do a better job of sticking to a medication regimen if they take generics, since the drugs are cheaper and people are more likely to get prescriptions filled. (If you're more likely to take a medication, you're more likely to get better.) Do generics work just as well? The committee found that the vast majority of the evidence showed generic drugs are as effective as brand-name medications when it comes to health outcomes. If your doctor prescribes a brand-name medication, ask if there's a generic that will do the same job and save you money.

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In the Journals

Adding muscle relaxers or narcotic pain relievers to the nonsteroidal anti-inflammatory drug (NSAID) naproxen (Aleve) did not improve pain or function for people who went to emergency rooms seeking help for severe low back pain, according to a study in The Journal of the American Medical Association.

The study followed a group of 320 people who visited the same emergency room in the Bronx, N.Y. None had symptoms that would suggest disk-related back pain, like shooting pain down the back of the legs (sciatica). They were all advised to take naproxen for 10 days and were chosen at random to add one of three additional pills: the muscle relaxer cyclobenzaprine (Flexeril); ox-ycodone (Percocet), a narcotic pain reliever; or a placebo.

In the Journals

Alpha blockers, a type of medication that many men take for urinary difficulties caused by an overgrown prostate, are associated with a dangerous but very small risk of falling, according to a recent study in BMJ. This should reassure men who have heard that the drugs could cause dizziness from a sudden drop in blood pressure.

The Canadian study identified more than 147,000 men in Ontario prescribed one of three drugs: alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax). Most of the men (84%) took Flomax, although all three drugs work the same way.

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Several medications can maintain or increase bone density. You can choose one based on your health and preferences.

Most of what we read about hip fracture isn't good. It is a major cause of disability, nursing home admissions, and death in older women. But there is a promising trend: hip fractures in the United States have been on the decline since 1996. Although better nutrition, increased physical activity, and education on fall prevention may have played a role, the drop in fractures has also coincided with the widespread availability of bisphosphonates—a class of drugs first approved in 1995 to increase bone density.

Flu season still has a few months left, and it is not too late to get a flu shot if you have not done so already. 
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They may help reduce symptoms of the flu, but they're not for everyone.

These innovative devices and procedures for diagnosing and treating heart conditions are on the horizon.

For the most part, the Harvard Heart Letter focuses on treatments that are already available for people with heart disease. In this article, we're making an exception. Editor in Chief Dr. Deepak L. Bhatt selected five innovative technologies in the world of cardiovascular health that he predicts we'll be hearing more about in the coming years.

Ask the doctor

Q. I take my blood pressure medication twice a day. Or at least I am supposed to, but I sometimes forget the second dose because my evenings tend to be really busy. What can I do?

A. One idea is to leave a sticky note on your bathroom mirror or near your bed as a reminder. Or try using an alarm (either a traditional alarm clock or one on a smartphone) that rings close to the time when you normally go to bed. You might also consider taking the second dose with dinner, assuming your doctor or pharmacist says it is okay to take your particular medicine with food.