Flu and heart disease: The surprising connection that should convince
you to schedule your shot

Date:
October 15, 2021
Source:
Houston Methodist
Summary:
Patients who have cardiovascular disease are at increased risk of
serious complications from the flu, according to a new study. The
study found that not only are traditional flu-related outcomes worse
among some patients with CVD, but infection in those patients
also is associated with an increased risk of cardiovascular
events. Getting the influenza vaccine, however, substantially
reduces cardiovascular risks.



FULL STORY ==========================================================================
If you have heart disease or risk factors for heart disease, you already
know about the increased risk of heart attack and stroke. But did you
know that coming down with the flu can substantially increase the risk
of a serious or even fatal cardiac event? Or that getting the influenza
vaccine can substantially reduce that risk, even if you do wind up
contracting the seasonal virus?

========================================================================== Probably not, if annual influenza vaccination rates are any indication, especially if you're under the age of 65. According to a Houston Methodist review published in the Journal of the American Heart Association,
Americans with heart disease continue to have low vaccination rates
every year despite higher rates of death and complications from influenza.

The flu vaccination rate for American adults who are less than 65 years
of age and have heart disease is less than 50%, compared to 80% in older
adults with heart disease.

"It seems that younger Americans with high-risk conditions have not
gotten the same memo that their older counterparts have received about the importance of getting the influenza vaccine," says Dr. Priyanka Bhugra, internal medicine specialist at Houston Methodist and lead author of the
JAHA article. "That's dangerous, considering people with heart conditions
are particularly vulnerable to influenza-related heart complications,
whether they've reached retirement age or not." It's well-known that
the flu can lead to significant respiratory symptoms such as pneumonia, bronchitis and bacterial infection of the lungs. The virus' effects on
the heart have historically been harder to parse out, in part because many patients already have a known predisposition to cardiac events and in part because the cardiac event often occurs weeks after the onset of the flu.

But here's what recent research has shown:
* Cardiovascular deaths and influenza epidemics spike around the
same time.

* Patients are six times more likely to experience a heart attack
the week
after influenza infection than they are at any point during the
year prior or the year after the infection.

* In one study looking at 336,000 hospital admissions for flu, 11.5%
experienced a serious cardiac event.

* Another study looking at 90,000 lab-confirmed influenza infections
showed
a strikingly similar rate of 11.7% experiencing an acute
cardiovascular event.

* One in eight patients, or 12.5%, admitted to the hospital with
influenza
experienced a cardiovascular event, with 31% of those requiring
intensive care and 7% dying as a result of the event, another
study found.

The reason influenza stresses the heart and vascular system so much has
to do with the body's inflammatory response to the infection.



========================================================================== Inflammation occurs when your body's "first responders" -- white blood
cells and what they produce in order to protect you -- convene in an
area and get to work fighting an infection, bacteria or virus. When
you're sick, you can typically feel the effects of these "combat zones"
in the swelling, tenderness, pain, weakness and sometimes redness and
increased temperature of your joints, muscles and lymph nodes.

The increased activity can also cause a traffic jam of sorts, leading
to blood clots, elevated blood pressure and even swelling or scarring
within the heart.

The added stressors make plaque within your arteries more vulnerable to rupture, causing a blockage that cuts off oxygen to the heart or brain
and results in heart attacks or strokes, respectively.

Additionally, non-cardiac complications from the viral illness, including pneumonia and respiratory failure, can make heart failure symptoms or
heart arrhythmia much worse.

In short, the added stress on the cardiovascular system could be
overwhelming to an already weakened heart muscle.

Because influenza viruses are constantly mutating, scientists alter the
vaccine each year to match the likely prevalent strands. On average,
it's effective at preventing infection 40% of the time. While that might
not sound great - - especially in comparison to the highly effective
mRNA COVID-19 vaccines - - it's enough to significantly lower the risk
of severe illness in most people.



========================================================================== Lately, studies have been able to show that not only is the vaccine
effective at protecting the general population and the most vulnerable
age groups (over 65 and under 2) from severe cases of the flu, but it's
also protective against cardiovascular mortality as well, especially
among the high-risk population.

Some of the recent findings:
* Adults who received the vaccine were 37% less likely to be
hospitalized
for the flu and 82% less likely to be admitted to the ICU because
of it.

Among people admitted to the hospital with the flu, those vaccinated
were 59% less likely to be admitted to the ICU. Vaccinated
patients admitted to the ICU spent four fewer days in the ICU than
unvaccinated patients.

* Vaccination was associated with a lower risk of cardiovascular
events
(2.9% vs 4.7%) if the patient got the flu. Among the highest-risk
patients with more active coronary disease, vaccination was
associated with considerably better outcomes.

* Patients admitted to the hospital with acute coronary syndrome were
randomly assigned to either receive a flu vaccine or not before
discharge. Major cardiovascular events occurred less frequently
in the vaccine group than the control group (9.5% vs. 19%).

As a result of the demonstrated benefits conferred by influenza
vaccination and the risks posed by flu infection among those with cardiovascular disease, the CDC and numerous other international
societies strongly recommend annual influenza vaccination in patients
with cardiovascular disease.

Clinicians should ensure high rates of influenza vaccination, especially
in those with underlying chronic conditions, to protect against acute cardiovascular events associated with influenza.

Unfortunately, many heart patients visit their cardiologist more
frequently than their primary care providers, and cardiology practices typically do not provide flu vaccinations, though proposed recommendations
may change in the future. Until then, it is incumbent upon both the
cardiology provider and the primary care provider to communicate the
increased risk to their patients and the importance of getting vaccinated.

For patients with heart conditions, there are two important steps you
can take to reduce your risk:
* Make sure you do obtain your influenza vaccine from your local
pharmacy
or primary care provider. The earlier you get it, the better it
is at protecting you, as you never know when the virus may begin
to spread.

* Make sure you are taking your medications and following your
recommended
diet, exercise and stress reduction plans. If your heart condition
is stable and you end up with the flu, chances are you'll experience
fewer, less severe complications than if your heart condition is
poorly managed.

========================================================================== Story Source: Materials provided by Houston_Methodist. Original written
by Eden McCleskey.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Priyanka Bhugra, Gowtham R. Grandhi, Reed Mszar, Priyanka Satish,
Rahul
Singh, Michael Blaha, Ron Blankstein, Salim S. Virani, Miguel
Cainzos‐Achirica, Khurram Nasir. Determinants of Influenza
Vaccine Uptake in Patients With Cardiovascular Disease and
Strategies for Improvement. Journal of the American Heart
Association, 2021; 10 (15) DOI: 10.1161/JAHA.120.019671 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/10/211015184212.htm

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