
High Pain Tolerance Linked to Silent Heart Attack
Not all heart attacks come with warning signs. Those that don’t—silent heart attacks—carry a poorer prognosis because patients often don’t seek medical care in a timely manner. Results from a new study from Norway indicate that people with higher pain tolerance are more likely to experience such silent heart attacks.
The researchers studied almost 5,000 people who underwent both a brief test of pain tolerance through exposure to ice-cold water and an electrocardiogram (ECG) to look for signs of damage from a previous heart attack. Participants’ medical records were also reviewed to see if they had ever been diagnosed with a heart attack, either symptomatic or silent.
More of the participants had experienced a silent heart attack than a symptomatic one: 8% versus 4.7%. On average, those diagnosed with a silent heart attack endured the cold-exposure test for significantly longer than people whose heart attacks had symptoms. This association was stronger in women than in men. Such a reduced sensitivity to pain may help explain the lack of symptoms associated with silent heart attack, wrote the study authors.
- Read the full article in the Journal of the American Heart Association

Heart Disease Risk Much Greater in People with Less Education
People who leave high school without a diploma have more than double the rate of heart attack than people who have a university degree, according to new data from the Australian 45 and Up Study. Those with intermediate education—but no university degree—have a risk of heart attack about two-thirds higher than college graduates.
These results came from following over a quarter of a million Australian men and women aged 45 to 64 for five years. Stroke risk also correlated with education level in the study. People without a high-school diploma were 50% more likely to have a first stroke than those with a college degree. Those with intermediate education were 20% more likely to have a stroke.
“This research demonstrates…how much worse the inequalities in cardiovascular disease are than we previously thought,” said Emily Banks, PhD, scientific director of the 45 and Up Study, in a press release. However, she added, “This research also provides important clues about how much cardiovascular disease can be prevented.”
- Read the full article in the International Journal for Equity in Health

Women Have Better Survival One Year after TAVI
Though women are thought to be at higher risk of complications from transcatheter aortic valve implant (TAVI) than men, they have a higher survival rate than men one year after the procedure, according to a new study.
Researchers looked at data from a large registry of patients who underwent TAVI with older-generation devices between 2011 and 2014. Out of more than 23,000 patients, about half were women. Overall, the women were older, had higher predicted risk scores for early complications and were more likely to have other health issues before the procedure. They also experienced more complications related to their blood vessels while in hospital. However, death rates one year after the procedure were lower in women compared with men: 21.3% versus 24.5%.
“These findings are significant because it may mean heart teams are overestimating the risks of [TAVI] in some women and that also may mean that valve replacement is underutilized. In other words, some women who could benefit from TAVI may not be getting it,” said the study’s senior researcher, Roxana Mehran, MD, in an accompanying press release.
- Read the full article in JACC (Journal of the American College of Cardiology)