Medications Archive

Taking an aspirin can protect you from heart attack, blood clots and more

First marketed by the Bayer Company in 1897, aspirin (acetylsalicylic acid) is one of our oldest modern medications — and its parent compound is much older still, since Hippocrates and the ancient Egyptians used willow bark, which contains salicylates, to treat fever and pain. Over the past 100 years, aspirin has made its way into nearly every medicine chest in America. Indeed, this old drug is still widely recommended to control fever, headaches, arthritis, and pain.

Although aspirin remains an excellent medication for fever and pain, other drugs can fill these roles equally well. But aspirin has a unique role that was not even suspected by its early advocates. In patients with coronary artery disease, aspirin prevents heart attacks.

Ask the doctor

Q. Should I take aspirin if I think I'm having a heart attack, and what kind of aspirin should I take?

A. First, what symptoms indicate you might be having a heart attack? The main symptom is a squeezing, tight sensation in the middle of the chest that can travel up into the jaw and shoulders, and even down the left arm. Along with the pain you may begin to sweat and to feel weak, like you might pass out, and be short of breath. While other conditions besides a heart at-tack can cause similar symptoms, you need to take such symptoms very seriously. First, call 911.

Overall risk is very small, and older women who used hormonal contraceptives many years ago aren't likely to have a higher risk.

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Hormonal birth control — whether it comes as pills, injections, a ring, an intrauterine device (IUD), or an implant — may raise your risk of breast cancer, according to a study published Dec. 7, 2017, in The New England Journal of Medicine.

If you're like many women who currently use one of these contraceptive methods, or if you used one for years in the past, should you be worried?

On call

Q. My feet tingle or feel numb like they are asleep at times, mostly when I am in bed or with my legs elevated. What causes that?

A. The symptoms you describe may be related to peripheral neuropathy, which is nerve damage that affects multiple nerves leading out from the spinal cord to the arms and legs. Symptoms are often equal in both feet. If only one foot, or part of a foot, is affected, this suggests compression of an individual nerve.

A new study suggests that hormone therapy might help with perimenopausal depression. But is it safe for you?

Hormone therapy has long been a controversial topic, and a new study about the role of hormones in depression is adding some fodder to the debate. A study published in the January 10 issue of JAMA Psychiatry determined that hormone therapy may help ward off symptoms of depression in women. Researchers found that perimenopausal and early postmenopausal women who were treated with hormones were less likely to experience symptoms of depression than women in the study who were given a placebo.

But while the findings of the study are important — particularly considering that a woman's risk of depression doubles or even quadruples during the menopausal transition — that doesn't mean hormone therapy should be widely used for preventing depression in women at this stage of life, says Dr. Hadine Joffe, the Paula A. Johnson Associate Professor of Psychiatry in Women's Health at Harvard Medical School, who wrote an editorial accompanying the study. "It's not a 'never,' but it shouldn't be a standard approach; in general, all of medicine has moved away from using hormones for prevention," she says.

Ask the doctor

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Q. I recently got a coronary artery calcium scan and the results showed that I have quite a bit of calcium in my heart arteries (my score was 900). Should I have an angiogram to confirm the results? I don't have any heart-related symptoms, but I'm worried about having a heart attack.

A. That is a very high coronary artery calcium score. But the short answer to your question is no. The main reason to have an angiogram is to locate a narrowed heart artery that is causing chest pain or other symptoms. For the test, a cardiologist injects a dye that is visible on x-rays into the blood vessels of your heart, then takes a series of x-ray images. This is done in preparation for angioplasty, in which a narrowed artery is opened, or as a prelude to referral for coronary artery bypass surgery.

Research we're watching

A team of scientists have created a tiny heart muscle "pump" using human cells and a three-dimensional bioprinter. The model heart — which was sized to fit inside a mouse's abdominal cavity — may one day prove useful for studying new heart medications and other therapies, they say.

The researchers first tried using heart muscle cells (cardiomyocytes) in the 3D printer, but the cells didn't grow to a sufficient size and volume. So they instead used so-called pluripotent stem cells, which have the ability to transform into different cell types. After printing a chambered structure, they were able to program the stem cells to become cardiomyocytes, which then began to organize and work together. Within about a month, the cells began beating together, similar to a human heart. The research is detailed in a study published July 3, 2020, in the journal Circulation Research.

Research we're watching

A recent study found that nearly one in 10 people who received opioid pain relievers following heart surgery continued to take them for three to six months — a time point when no one should still be experiencing pain from the operation.

The study included nearly 36,000 people with private health insurance who had a coronary artery bypass graft (known as CABG or bypass surgery) or a heart valve replacement between 2003 and 2016. People who were prescribed more than 40 5-mg tablets of oxycodone (Oxycontin, Roxicodone, others) or an equivalent amount of a similar drug were at a much higher risk of prolonged opioid use than people who were prescribed lower doses. Other factors that increased a person's odds of taking opioids long-term included having CABG, being female, or having a history of chronic pain or alcoholism.

How can you protect yourself from both viruses?

With flu season here and the COVID-19 pandemic ongoing, what can people expect when these two illnesses meet?

It's anyone's guess.

"While we're in the midst of the COVID pandemic, there's a lot of uncertainty about what will happen when this collides with our yearly flu epidemic," says Dr. Mary Watson Montgomery, an infectious disease expert at Harvard-affiliated Brigham and Women's Hospital.