Heart Attack Archive

In the journals

People who have had a heart attack or a stroke are routinely prescribed a statin to reduce the risk of a repeat event. But by also following a Mediterranean-style diet, they can improve their chance of living longer, suggests a study in the Feb. 1, 2019, issue of the International Journal of Cardiology.

The study looked at 1,180 people, average age 68, who had at least one previous heart attack or stroke, and recorded their statin use and diet intake at the study's beginning. The researchers identified the people who faithfully followed a Mediterranean-style diet. A Mediterranean-style diet involves consuming medium to high amounts of whole fruits and vegetables, whole grains, legumes and nuts, olive oil, and poultry and fish, with limited amounts of red meat, alcohol, and dairy.

Why do heart attack rates rise on Monday mornings and the week after daylight savings time begins?

Deep inside your brain is a small cluster of cells that serves as your body's master clock. These cells govern your circadian rhythm, the 24-hour internal clock that keeps your body in sync with the day-night cycle. But nearly all your cells also have their own clocks to ensure that each one performs its unique role — such as producing proteins or releasing hormones — at the right time.

These biological timekeepers are under genetic control. But what happens if our behavior or environment is out of sync with our internal clocks? Understanding the potential health consequences of that misalignment is the focus of the Medical Chronobiology Program at Harvard-affiliated Brigham and Women's Hospital, says Dr. Frank Scheer, who directs the program.

People with fluctuating numbers — like blood pressure, cholesterol, and weight — may be at higher risk of heart attack, stroke, and even death.

 Image: © RapidEye/Getty Images

Most people battle "yo-yoing" at some point, when their weight, blood pressure, or some other health number keeps going up and down.

On the surface, this may not seem like a problem if you routinely hit the healthy numbers. Yet new research suggests that fluctuations like this may pose a greater health risk than staying at a single level, even if it's not a perfect one.

In the journals

Vitamin D and omega-3 fatty acid supplements have had mixed results when it comes to preventing heart attacks, strokes, and cancer in people who have already developed these problems or are at high risk for them. Yet a new study published online Nov. 10, 2018, by The New England Journal of Medicine found they may actually prevent these conditions among people who have never had these problems before.

Researchers recruited almost 26,000 people, ages 50 and older, who had no history of heart disease or cancer. The participants were divided into four groups. People in one group were given daily doses of 2,000 international units of vitamin D (an amount found to be linked to lower disease risk in observational studies) and 1 gram of a drug called Lovaza, which contained 840 milligrams of omega-3s (two to four times the amount in two servings of fish per week). The second group took vitamin D and a placebo, the third group took the omega-3s and a placebo, and the final group took two placebos. After more than five years, the researchers found that those given omega-3s were 28% less likely to suffer a heart attack compared with those given a placebo. Those who ate fewer servings of fish (less than the average of 1.5 servings per week) appeared to have a greater benefit from the additional omega-3s while those with higher fish intake had minimal benefit.

Ask the doctors

Q. My partner recently had a heart attack. The doctor recommended exercise, but I wonder if it's better to take it easy. I feel like exercise might be dangerous or even cause another heart attack. Is exercising too risky?

A. As counterintuitive as it might seem, exercise is good medicine for heart attack survivors. Provided the doctor gives the green light, about two-and-a-half hours of moderate-intensity exercise each week can be beneficial — this is the amount recommended by the American Heart Association. Exercise can start as soon as the doctor gives the okay.

A "type 2" heart attack caused by severely restricted blood flow can be just as serious as a heart attack caused by a sudden complete blockage.

 Image: © PeopleImages/Getty Images

In TV shows and movies, a man having a heart attack typically clutches his chest and falls to the ground, but most heart attacks are not nearly as dramatic.

"No two heart attacks are the same, nor do they strike in similar fashion," says Dr. Krishna Aragam, a cardiologist with Harvard-affiliated Massachusetts General Hospital. "Some heart attacks are subtler in their warnings, but can be just as serious and even deadly if they are not attended to."

Research we're watching

 Image: © pashapixel/Getty Images

A tendon that stretches between your heel and your calf may tell you something about your cardiovascular health. Researchers found that people with thicker Achilles tendons have more significant coronary artery disease and are at higher risk for a heart attack than those with thinner tendons.

The study, which was presented in November 2018 at the American Heart Association's Scientific Sessions meeting in Chicago, found that people with thicker Achilles tendons were more likely to have a blocked heart artery and left main coronary artery disease, which is associated with a high risk of heart disease and death. It's unclear, however, exactly why this artery was thicker in these individuals.

 Image: © Hunterann/Thinkstock

Research we're watching

For years, many have speculated that taking vitamin D and omega-3 fatty acid supplements might help to prevent heart attacks, strokes, and certain cancers. But a study by Harvard researchers published online November 10, 2018, by The New England Journal of Medicine has found that the benefits may be more limited than originally hoped.

The results of the Vitamin D and Omega-3 Trial (VITAL), which enrolled more than 25,000 people and ran for more than five years, showed that while omega-3 supplements did appear to reduce the risk of heart attack, particularly among African Americans, they did not appear to be effective in preventing stroke or cancer. Vitamin D supplements also saw few benefits when it came to preventing heart attack, stroke, or cancer — but they were associated with a drop in cancer deaths in people who had taken the supplements for at least a year or two.

Research we're watching

 Image: © Neydtstock/Getty Images

Electronic cigarettes, which are battery-operated devices that create a nicotine-filled vapor, are often touted as a less-risky alternative to conventional cigarettes. But daily e-cigarette use may nearly double a person's risk of a heart attack, according to a study in the October 2018 American Journal of Preventive Medicine.

The data came from nearly 70,000 people who took part in two National Health Interview Surveys. Compared with nonsmokers, people who smoked regular cigarettes daily nearly tripled their heart attack risk, compared with a nearly doubled risk among people who used only e-cigarettes. However, about two-thirds of current e-cigarette users also smoked regular cigarettes. Using both products daily was linked to a nearly fivefold increase in heart attack risk.

But use is primarily a concern for people who take them over a long period or who have certain health risks.

 Image: © clu/Getty Images

Numerous studies in recent years have raised concerns that common pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of cardiovascular problems, such as heart attack and stroke.

A study published September 4 in The BMJ seems to confirm the risks associated with NSAIDs and notes that one medication in particular — diclofenac (Voltaren) — is associated with even higher risks to cardiovascular health than others in the same category.