Heart Attack Archive

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").

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.

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.

Research we're watching

If you've had a heart attack, national guidelines strongly recommend taking a high-intensity statin to prevent a second heart attack. But a study of Medicare recipients finds that where you live may affect your chances of receiving a statin prescription.

People living in New England were most likely to receive a high-intensity statin (74%), while those from the West South Central states (such as Arkansas, Oklahoma, and Louisiana) were the least likely (41%). The data came from nearly 140,000 people ages 66 and older who were hospitalized for a heart attack from 2011 to 2015. The findings were published online July 24 by JAMA Cardiology.

Heart attacks may leave people more vulnerable to thinking and memory problems as they age.

Growing older often means slowing down, both physically and mentally. Just as people can't move quite as fast as when they were younger, their thinking and memory abilities — known as cognitive function — may also slowly wane.

Now, new research suggests that people who have a heart attack or angina (chest pain caused by reduced blood flow to the heart) may face a faster drop in thinking skills than people who don't experience those heart-related problems.

Research we're watching

Eating ultra-processed foods — such as packaged snacks, sugary cereals and drinks, chicken nuggets, and instant soup — may leave people more prone to heart disease and an early death, two new studies suggest. Both were published May 29 in The BMJ.

One study followed more than 105,000 adults for just over five years. Researchers found that for every 10% increase in the amount of ultra-processed foods people ate, their risk of a heart attack, stroke, or other serious cardiovascular event was 12% higher. The other study tracked nearly 20,000 people over an average of 10 years. People who ate more than four servings of ultra-processed foods daily had a 62% higher risk of dying from all causes compared with those who ate only two servings per day.

A substance called trimethylamine N-oxide, which is produced when your body digests red meat, may raise the risk of cardiovascular problems.

Experts used to think that red meat raised your risk of heart disease simply because it was high in saturated fat. But today that picture has gotten more complicated thanks to the discovery of a metabolite — a substance produced during digestion and metabolism — called trimethylamine N-oxide, or TMAO.

According to a news article published June 11 in JAMA, three recent analyses have linked high blood levels of TMAO with a higher risk for both cardiovascular disease and early death from any cause. In one of those studies, researchers found that people with higher levels of TMAO in their blood may have more than twice the risk of heart attack, stroke, or other serious cardiovascular problems, compared with people who have lower levels. Other studies have found links between high TMAO levels and heart failure and chronic kidney disease.

Research we're watching

If you have coronary artery disease, you may be at higher risk for cognitive problems, according to a study published in the June issue of the Journal of the American College of Cardiology. People with coronary artery disease have blockages in the arteries that lead to the heart. When blood flow to the heart is slowed or blocked, the result can be a heart attack or the chest pain known as angina.

Study authors looked to see whether this condition had any effect on thinking skills. They selected people with no history of heart disease and followed them for 12 years, administering three cognitive tests throughout the course of the study. Ultimately, 5.6% of people in the study experienced a heart attack or angina. Researchers found that these people were not more likely to have experienced cognitive decline before their heart episode or immediately after, but were at much higher risk for cognitive decline in the years that followed. It's not clear why this occurred, but the study authors say that doctors should be aware of this risk and should monitor people with coronary artery disease carefully.

The simple version of cardiopulmonary resuscitation — pushing hard and fast on the chest — can double a person's odds of surviving cardiac arrest.

If someone suddenly collapses and stops breathing, the most likely cause is cardiac arrest. An electrical malfunction causes the heart to beat rapidly and chaotically — or to stop beating altogether. But if a bystander immediately begins chest compressions, which mimic the heart's pumping action, blood keeps flowing to the person's brain.

For more than a decade, guidelines have recommended this simpler version of cardiopulmonary resuscitation (CPR), which does not involve the mouth-to-mouth breathing used in standard CPR.

Q. After my heart attack, my doctor told me that damaged heart muscle cannot be replaced. If this is true, why am I walking on a treadmill five days a week? Is this helping repair the heart muscle damage or strengthen what's left of my heart muscle?

A. Your skeletal muscles can repair themselves after an injury — pull your calf muscle and, after a few days or so, it heals. Until recently, it was believed that the human heart didn't have this capacity. But the heart does have some ability to make new muscle and possibly repair itself. The rate of regeneration is so slow, though, that it can't fix the kind of damage caused by a heart attack. That's why the rapid healing that follows a heart attack creates scar tissue in place of working muscle tissue.