Heart Attack Archive

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Is nighttime the right time for blood pressure drugs?

Taking these medications at bedtime rather than in the morning may make them more effective.

Many people take their medications as part of their morning ritual, along with a cup of coffee and the daily newspaper. But for blood pressure drugs, evening may be a better option. Last year, a large study found that taking blood pressure drugs before bed may lower the risk of serious heart-related complications more than taking the drugs in the morning (see "Benefits of bedtime blood pressure dosing").

The concept of chronotherapy, or adjusting medication dosing to a specific time of day, isn't new. There's not a great deal of evidence to support the practice with cardiovascular drugs, but it makes sense, says Dr. Naomi Fisher, director of the Hypertension Specialty Clinic at Harvard-affiliated Brigham and Women's Hospital.

How better blood pressure control may benefit the brain

Research we're watching

Treating high blood pressure may do more than prevent heart attacks and strokes. In older adults, intensive blood pressure lowering may also conserve brain function, according to a new study.

Published online Oct. 14, 2019, by the journal Circulation, the study included 199 adults ages 75 and older, all with a systolic blood pressure value (the first number in a reading) of 150 or higher. Their brain scans also showed lesions in the brain's white matter, which contains nerve fibers that send signals from one part of the brain to another. The lesions, which reflect damaged small blood vessels, have been linked to a propensity for thinking and memory problems. About two-thirds of people over age 75 have white matter lesions, as do most people over age 90.

Omega-3 supplements may improve heart health

In the journals

Research continues to explore the possible benefits of omega-3 fish oil supplements, especially for heart health, and a recent review of existing data suggests they may protect against heart attack and coronary artery disease.

Researchers from Harvard's T.H. Chan School of Public Health and Brigham and Women's Hospital examined 13 trials, involving almost 128,000 people, to look for any association between omega-3 supplements and the risk of heart attacks, strokes, coronary artery disease, and death from cardiovascular disease. Their results were published online Sept. 30, 2019, by the Journal of the American Heart Association.

Hot flashes and heart health

This symptom is common in menopause, but frequent or persistent episodes could be a sign of higher risk for heart attack or stroke.

Researchers have begun to pay more attention to cardiovascular risk factors that are unique to women, such as early menopause (before age 40) and certain pregnancy complications. Recently they turned their attention to a common menopausal symptom that affects up to 85% of women: hot flashes.

Study results presented in September 2019 to the North American Menopause Society from the Study of Women's Health Across the Nation (SWAN) found that women who experience frequent or persistent hot flashes may be more likely than women who don't to experience a heart attack or stroke or other serious cardiovascular problems. (Researchers defined "frequent" hot flashes as having them six or more days in the previous two-week period. Women with "persistent" hot flashes reported those frequent hot flashes at 25% or more of study visits.)

Advice about taking aspirin and statins after age 75

These drugs are mainstays for preventing heart disease. Are they safe and effective in older people?

Low-dose aspirin and statins are both common, inexpensive drugs that help prevent the two root causes of most heart attacks — blood clots and cholesterol-laden plaque clogging the arteries of the heart. In recent years, a number of studies have helped experts refine their advice as to who should or should not take these medications.

However, evidence-based advice for people in their mid-70s and beyond is a bit harder to come by. Historically, most drug trials have included only a small proportion of people 75 and older, in part because there are fewer people in that age demographic. Also, older people tend to have other chronic health conditions. As such, they may be more prone to drug side effects, making doctors reluctant to enroll them in clinical trials.

Who needs aspirin?

Age, family history, and other risk factors determine if daily aspirin can help prevent a heart attack or stroke.

For many of us, aspirin was the go-to medicine of our youth. Everything from headaches, colds, and general aches and pains were treated with two aspirin and a glass of water.

For decades, aspirin was widely believed to be a safe way to protect healthy adults from heart attacks and strokes. But over the past couple years, new research has questioned this premise and many doctors have already stopped prescribing aspirin for adults at low risk of cardiovascular disease.

Flu shot may lower risk of early death in people with high blood pressure

In the journals

Need another reason to get your annual flu shot? It could protect you from a fatal heart attack or stroke if you suffer from high blood pressure, according to research presented at a 2019 joint conference of the European Society of Cardiology Congress and the World Congress of Cardiology.

Previous research has found that the inflammation from a flu infection can trigger a heart attack or stroke, and people with high blood pressure are especially at high risk.

A major change for daily aspirin therapy

New recommendations could affect millions of people.

You may remember a time when taking a daily baby aspirin was almost a rite of passage for generally healthy older adults. The idea was that, for people with a low to moderate risk for heart disease, aspirin therapy was a simple and cost-effective way to help prevent a heart attack or stroke.

But taking aspirin increases the risk for bleeding in the stomach and brain (see "How aspirin affects the body").

Were the old aspirin studies wrong?

Ask the doctor

Q. For 25 years, my doctor has recommended low-dose aspirin to reduce my risk of a heart attack. Recently, he told me that new studies indicate that I can stop. What's changed?

A. Millions of people are asking the same question. I'm afraid some of them think that, when doctors change their recommendations, it means we really don't know what we're doing. To the contrary, the recommendation you got 25 years ago was based on sound scientific evidence, and so is the recommendation you received recently.

Winter weather warning

When the temperature drops, the risk of a heart attack rises. Here's how to stay safe in chilly weather.

Cold weather — especially when it's windy or snowy — can challenge your cardiovascular system. When you venture outside, the tiny blood vessels in your fingers and toes squeeze tight to shunt blood deeper into your body, keeping your vital organs nice and cozy.

To overcome the resistance from those narrowed vessels, your heart beats with extra force, causing your blood pressure and heart rate to rise. This normal physiological response usually isn't a problem, especially for healthy people.

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