Heart attack – also called cardiac arrest or myocardial infarction – is the leading cause of mortality in the United States, with about 1 in 4 deaths related to heart disease. The most common cause of heart attack is coronary heart disease, a blockage of blood vessels, resulting in a lack of oxygen that leads to tissue death.
Heart Attack Risks: What Consumers Should Know
Many people know that age, gender, lifestyle, diet, genetics, and overall health play an important role in heart failure. However, many people are unaware that the prescription medicines they take, or the medical devices they use, could greatly increase the likelihood of having a heart attack.
While drug and medical device manufacturers are required to list harmful effects of their products, it can sometimes take years of studies to identify and confirm side effects. It is important always to discuss potential heart-related side effects with your doctor or pharmacist before starting a new prescription, so you know how it could affect you and what you might need to do if you suffer from a cardiac event.
Common Risk Factors for Heart Disease
- Smoking (nicotine)
- Physical inactivity
- Poor diet
- High cholesterol (LDL)
- Type 2 diabetes
- Family history
Drugs That Increase Heart Attack Risk
While we typically think of medications as helping us with health problems, there are many drugs that can have severe side effects. In some cases, these side effects are much worse than the treatment value of the drug, leading to permanent damage and possibly even death – such as by increasing the risk of a heart attack.
Blood thinners are meant to prevent or dissolve blood clots, which is supposed to reduce the risk of life-threatening health conditions like stroke, pulmonary embolism, and heart attack. However, several studies have shown that some anticoagulants can actually increase the risk of heart failure, especially when combined. Patients who take certain prescription blood thinners, such as Pradaxa and Xarelto, have a much higher risk of suffering a heart attack than those who take warfarin.
Proton-pump inhibitors (PPIs) are prescribed to treat various gastrointestinal health issues, including everything from heartburn and gas to Zollinger-Ellison syndrome, a condition in which the pancreas makes too much gastric acid and can lead to ulcers. The most popular PPIs include Nexium, Prilosec and Prevacid, all of which have been the subject of studies indicating that they put patients at a higher risk of heart attack.
Nonsteroidal anti-inflammatory drugs (NSAIDs) that treat arthritis, pain, swelling, and stiffness have been shown in medical studies to almost double the risk of heart attacks, along with increasing the risk of stroke, kidney damage, and other potentially severe side effects. NSAIDs include drugs like naproxen (Aleve) and ibuprofen (Motrin, Advil), which come in both over-the-counter and prescription strengths. Although aspirin is also an NSAID, it does not increase the risk of heart attack, and in fact is often used as a preventative treatment against heart attacks.
Although many women may not be aware of the risk, certain types of birth control are known to cause deep-vein thrombosis – that is, blood clots that can lead to stroke, pulmonary embolism, and heart attack. Specifically, hormone-based birth control containing estrogen can as much as double the risk of heart attack, according to a Danish study from 2012 that looked at the medical histories of more than 1.6 million women who took birth control over a 20-year period. Note that while there is an increased risk of heart disease in women who take hormonal birth control, the overall risk of heart attack is still low in women of reproductive age.
Testosterone Replacement Therapy
Men who use products like AndroGel or Androderm to treat low testosterone could be at a higher risk of developing cardiovascular disease, in addition to stroke and prostate cancer. While early studies have been questioned due to potential design flaws or small sample sizes, more recent studies have called for additional trials that look specifically at the side effects of testosterone therapy. While the exact risk is still yet to be measured, the FDA was concerned enough to require updates to the labels of testosterone replacement therapy drugs in 2015.
Medical Devices That Increase Heart Attack Risk
In addition to the medications listed above, some medical devices also can increase the risk of heart attacks and the development of cardiovascular disease.
Inferior Vena Cava (IVC) Filters
IVC filters have been around since the late 1970s as a way to prevent blood clots after major surgery; however, in the last 20 years or so, they have come under increasing scrutiny due to a host of problems. Among the many IVC filter complications are the possibility of migration, fracturing, and embolization – which can result in blood clots or pieces of the filter blocking the arteries and causing a heart attack.
Hip and Knee Replacement Devices
In addition to the risks of complications associated with any surgery, a 2015 study showed that the first month is especially dangerous for patients who undergo knee replacement or hip replacement surgeries. Specifically, the risk of heart attack increasing was 4x higher in people who had total hip replacements, and 8x higher in people who had total knee replacements. While that risk does diminish over time, the risk of developing a blood clot – which could lead to artery blockage and cause a heart attack – can actually increase as time goes on. Some brands of knee and hip joints, like Zimmer and DePuy, have proven to be somewhat more dangerous than others when it comes to such complications.
It may be hard to believe that implanting stents – known medically as percutaneous coronary intervention (PCI) – could put people at a higher risk of heart attack, given the purpose of a stent is to open a blocked artery and increase blood supply to the heart. However, a 2018 study published in The Lancet showed that PCI procedures had no effect compared with a placebo group, and with the invasive nature of the surgery, the complications of heart-related operations could be worse than the treatment.
Heart Attack Prevention and Management
The best way to prevent heart attack is to live a healthy lifestyle with the following elements:
- Physical activity that includes 150 minutes per week of moderate aerobic exercise (30 minutes x 5 days, or 50 minutes x 3 days, each week)
- Eating a healthy diet, such as reducing refined sugars and carbs while replacing unhealthy fats with healthier options, like olive oil and rapeseed oil
- Losing weight in a healthy, sustainable way
- Managing health conditions that could lead to heart attack, including obesity, diabetes, and hypertension (high blood pressure)
In some cases, individuals who have high cholesterol that cannot be managed through diet may also be prescribed drugs known as statins, which can help reduce the chances of a heart attack.
Unfortunately, even following all of the proper precautions may not necessarily prevent heart failure. If you believe you or a loved one exhibits any of the warning signs or symptoms of a heart attack, call 911 immediately!
Common Heart Attack Symptoms
- Chest pain, pressure or discomfort
- Pain or discomfort in the arms, back, neck, stomach, or jaws
- Shortness of breath (dyspnea)
- Cold sweat
- Lightheadedness or dizziness
Source: American Heart Association (AHA)
Heart Attack Treatment
Treatment for a heart attack generally focuses on retaining living heart muscle and the prevention of future complications, including further heart attacks. During and immediately after an acute myocardial infarction, the primary goal is to manage chest discomfort or pain and increase blood flow to the heart. This is done through the use of:
- Aspirin – a blood thinner that has been shown to help minimize heart damage during a cardiac event
- Nitroglycerin (nitrates) – a vasodilator drug, which relaxes the blood vessels and eases the heart’s workload
- Oxygen therapy – in some patients who have low oxygen levels, increasing oxygen supplied to the heart may help minimize damage during a heart attack
Longer-term treatment for coronary artery disease and other heart conditions may be necessary to prevent future heart attacks as well. These include taking beta blockers or undergoing a procedure such as angioplasty or bypass surgery. Cardiac rehabilitation, which provides training on how to safely and effectively exercise your heart along with education about how to eat healthy, is also an important part of preventing additional heart attacks.