by James Hubbard, MD, MPH

A couple of weeks ago I wrote about deciding what to do if you have chest pain far away from expert help. As usual my readers contributed some thought provoking comments. Two suggestions in particular inspired me to write additional posts. Last week I discussed so-called cough CPR. This week, it’s cayenne pepper.

The claim that cayenne pepper can stop a heart attack in its tracks is found far and wide on the Internet. So I decided to check out, as best I could, whether there’s any truth behind the headlines.

In fact, capsaicin, which is the chemical that makes peppers hot, does have some medical uses, which I’ve written about previously. It can relieve some types of pain and may fight certain cancers. It’s sold over-the-counter in a diluted nasal spray (for runny noses and headaches) and cream (for nerve pain). But whether it helps with a heart attack is more questionable.

Often, when the subject of cayenne and heart attacks comes up on the Net, a 2009 study is cited in which heart attacks were induced in mice. Rubbing some capsaicin paste onto their skin seemingly triggered some nerves there that, in turn, triggered other nerves in the body that protected the heart muscle from some damage. The reasons for the protection are still being investigated, but it appears to be that the nerves set off a complicated series of chemicals that try to protect injured heart muscle from further injury.

I couldn’t find any follow-up studies, so I tracked down W. Keith Jones, Ph.D., one of the lead investigators. At the time of the study, he was working at the University of Cincinnati Medical Center. He’s now the chairman of the molecular pharmacology and therapeutics department at Loyola University Chicago Stritch School of Medicine.

In our conversation, Dr. Jones started by stating that capsaicin never had been found to stop a heart attack in its tracks. It was only shown to help protect the heart muscle (in mice). He said that after the 2009 study, he had found it difficult to quantify the amount of capsaicin that might help the heart while at the same time be safe for human studies. He is now focusing on using an acupuncture-in-a-patch technique that triggers the same nerves as the capsaicin and is having promising results in mice. No human studies have been done. But, again, even though the patch might decrease the damage of a heart attack, it does not stop one.

So, why not use cayenne pepper just in case it could help? Well, it may not be good to take with aspirin, and we know aspirin can help.

Studies suggest taking an aspirin during a heart attack decreases the overall death rate. (It causes a 20 to 30 percent decrease in mortality; there’s no claim, however, that aspirin ever stops a heart attack in its tracks). The thing is, aspirin thins the blood. Cayenne pepper does too, to varying degrees. Taking both could potentially cause dangerous bleeding.

Also, with aspirin we have a good idea of the dosage needed and how much is in each pill. Cayenne may contain various amounts of the active ingredient, and even if we know the dose we’re getting, we don’t know how much is needed to prevent heart attacks and whether more than that would do more harm than good. (Granted, I’m not sure how much capsaicin gets into the body when rubbing it on. I’m guessing probably not much unless you rub on a lot. So applying it to the skin would have much less of a blood thinning effect than eating it.)

So, that’s what we know to date. Rubbing capsaicin on the skin of mice can significantly decrease heart-muscle damage if they have a heart attack. But even then, it doesn’t stop the heart attack.

And by the way, don’t let anything stand in the way of first calling 911 if it’s available. Here’s what you can do if it’s not.

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