Heart Medications Archive


Treating heart attacks: Changes from Eisenhower’s era to the present day

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."

What is a myocardial bridge?

Ask the doctor

Q. My 64-year-old brother had some transient chest pain while he was training for a cycling trip, so I urged him to see his doctor. Tests showed that he has a myocardial bridge. What does that mean?

A. The arteries that supply blood to the heart lie on the surface of the organ. But in some people, one of these arteries dives into the heart muscle and comes back out again, forming what's called a myocardial bridge. The bridge refers to the band of heart muscle (myocardium) that extends over that portion of the artery.

Atrial fibrillation: Shifting strategies for early treatment?

For people recently diagnosed, taming the heart's rhythm rather than slowing it down may be a better approach.

The heart rhythm disorder known as atrial fibrillation (afib) occurs when the heart's electrical system goes awry. Instead of the heart's natural pacemaker creating a steady beat, the heart's upper chambers (atria) pulsate rapidly — up to hundreds of times per minute. Most of the electrical impulses telling the lower chambers (ventricles) to contract don't get through but many do, triggering a racing, irregular heartbeat that can leave people dizzy, breathless, or fatigued.

Therapies to tackle this common arrhythmia have improved over the years. Now, new findings suggest it may be time to rethink the treatment for people newly diagnosed with afib (see "Afib: Rhythm vs. rate control").

3 supplements that may harm your heart

Labels on the bottles promise better health, but these supplements may wind up hurting you.

Keeping your heart healthy requires a combination of strategies, such as eating a healthy diet, exercising regularly, and managing stress. Adding a dietary supplement may seem like another means of protection.

But be careful. Unlike prescription medications, supplements are often sold without evidence that they work or they're safe. There's no way to know what's really inside pills or potions, since the FDA doesn't evaluate whether the manufacture of supplements is high quality, such as whether the pills are free from impurities. The following supplements may pose heart risks.

Two clot-prevention drugs for people with heart disease and diabetes?

Research we're watching

People with clogged arteries in their hearts (coronary artery disease) or legs (peripheral artery disease) face a high risk of having a heart attack or stroke, particularly if they also have diabetes. For such people, a combination of clot-preventing drugs lowers the risk of those dangerous outcomes, according to a study published online March 28 by the journal Circulation.

The study included just over 18,300 people with coronary or peripheral artery disease; about 38% also had diabetes. They all took low-dose aspirin daily, but half also took 2.5 milligrams of rivaroxaban (Xarelto) twice daily while the others took a placebo. Like aspirin, rivaroxaban helps discourage blood clots, but through a different mechanism.

Afib: Rhythm or rate control

Ask the doctor

Q. I was diagnosed with atrial fibrillation and my cardiologist prescribed metoprolol [Lopressor], which I understand is also used to treat angina. But I rarely have any chest pain. I was wondering if I should instead be getting another kind of medication to treat my condition?

A. During a bout of atrial fibrillation (afib), the heart beats very rapidly and irregularly. As a result, the heart may not pump effectively, which may cause symptoms such as breathlessness and fatigue. These episodes may be occasional and fleeting, or they may last hours, days, months, or even years.

Digestive tract bleeding may signal colon cancer in people taking blood thinners

In the journals

Bleeding is a common side effect of anticoagulants (blood thinners). However, people with atrial fibrillation (afib) who take the drug for stroke prevention should not ignore any bleeding from their lower gastrointestinal (GI) tract, as it may signal colon cancer. That study finding was published online Feb. 7, 2020, by the European Heart Journal.

Researchers analyzed 125,418 patients who took anticoagulants for afib. Only 2,576 had lower GI bleeding during the first six months of treatment, regardless of age. Yet those who did experience bleeding had 10 times the risk of being diagnosed with colon cancer during the subsequent year compared with those who hadn't had any bleeding.

Taking heart medications? Don’t forgo healthy habits

Research we're watching

People may let healthy eating and exercise habits slide after starting prescription heart medications, according to a study in the February 18 Journal of the American Heart Association.

The study involved more than 40,000 Finnish people whose average age was 52. From 2000 to 2013, researchers surveyed them at least twice every four years about their body mass index and their exercise, smoking, and drinking habits. They used pharmacy records to track if the participants began taking blood pressure drugs or statins.

2020 vision: Cardiology trends to watch

Several new technologies and medications that may benefit the heart are moving into cardiology care.

As regular readers of the Heart Letter know, our features tend to focus on lifestyle advice and currently available therapies for heart disease. As the new decade begins, we're also looking to the future. Editor in Chief Dr. Deepak L. Bhatt selected five promising new developments in cardiovascular research that you may be hearing more about in the coming years.

1. Digital stethoscopes

First developed more than 200 years ago, the instrument doctors use to listen to the heart and lungs has undergone some high-tech improvements in recent years. The latest digital stethoscopes feature specialized microphones and sensors that filter, buffer, and amplify sounds from the heart. The sounds are then converted to a digital signal and sent wirelessly to a smartphone, where the patterns can be visualized and further analyzed. Some models are so sensitive they can detect turbulent blood flow in the arteries of the heart, possibly enabling doctors to detect coronary artery disease. Studies assessing that potential use are currently under way.

Understanding blood thinners

Drugs that discourage blood clots (commonly called blood thinners) don't actually make the blood less viscous. The two main types of these drugs, anticoagulants and antiplatelet drugs, interfere with different blood components involved in clot formation. Anticoagulants treat blood clots in the legs and lungs and are also prescribed to people with atrial fibrillation. Antiplatelet drugs are used to prevent heart attacks and strokes and to treat people who receive stents.

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