ROANOKE TIMES 
                      Copyright (c) 1996, Roanoke Times

DATE: Monday, July 15, 1996                  TAG: 9607150108
SECTION: NATIONAL/INTERNATIONAL   PAGE: A-4  EDITION: METRO 
DATELINE: PORTSMOUTH, N.H.
SOURCE: Associated Press


HEART ATTACKS DON'T HAVE HAIR TRIGGERS

A HEART EXPERT tells patients not to worry about sex, anger or sudden exertion.

Yes, heart disease patients can get a heart attack from having sex, getting angry or exerting themselves. But for most patients, an expert has this advice: Don't worry about it.

In most cases, the risk of a heart attack is still small even after one of the potential heart-attack triggers, says Dr. James Muller, director of the Kentucky Heart Institute at the University of Kentucky in Lexington.

Although heart attack triggers should not worry most people, they do account for at least 17 percent of heart attacks, Muller said. So he said it's important to study them and find ways to keep them from causing harm.

Muller spoke in an interview before discussing heart attack triggers Sunday at a meeting of the American Heart Association. His don't-worry message about sex received wide publicity in May when he published a study in the Journal of the American Medical Association.

Muller said people with heart disease should talk to their doctors to see if the don't-worry message about triggers applies to them.

It wouldn't apply to people with unstable angina, who get chest pain without any exertion. Nor would it apply to patients who have a narrowing of the aortic valve, which is one of the main valves of the heart, Muller said.

But sedentary heart disease patients should be cautious about sudden heavy exertion, he said. And people who are angry all the time, even if they're not heart patients, should get counseling or learn stress-reduction techniques.

Dr. Sidney Smith, chief of cardiology at the University of North Carolina at Chapel Hill, said further research is needed to determine which groups of patients are particularly vulnerable to triggering. That knowledge should lead to recommendations for doctors, he said.

For a healthy 50-year-old man or a healthy 60-year-old woman, Muller said, the risk of a heart attack in any given hour without any trigger is about one in a million. Even in a typical heart disease patient, this ordinary risk is 1 in 100,000, he said.


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