Can just getting sick increase your risk for heart disease? Accumulating research suggests so.
Researchers have long noted a connection between infections like influenza and atherosclerosis. Moreover, the flu vaccine has been linked to a lower risk for cardiovascular events, including heart attacks and stroke, in the year following vaccination.
Accumulating evidence shows a similar phenomenon is at work with more serious infections, such as pneumonia and sepsis. A recent study in the European Journal of Preventive Cardiology found that lung and blood infections requiring admission to the hospital were associated with a six times greater risk for cardiovascular disease in the year following the illness, compared to people who hadn’t been waylaid by the conditions. Heart risk was more than twice as high for the hospitalized patients in years two and three following the event, and it persisted up to the fifth year post-infection.
The study included more than 235,000 men who were followed from adolescence to middle age. To explore the connection, researchers looked at a first infection with sepsis or pneumonia requiring hospitalization and later cardiovascular disease. Although they took into account other heart disease risk factors, including high blood pressure, obesity, and poor physical conditioning, infection was the most significant factor in the subsequent development of heart disease.
Other research has produced similar findings. In a 2016 Journal of the American Medical Association study, researchers found that over a ten-year period, cardiovascular events were higher among people who had been hospitalized for pneumonia, compared to healthy controls—people who were similar in every other respect.
The risk was particularly elevated in the first year after hospitalization and it varied according to the severity of disease and the presence of other heart disease risk factors. The overall trend was undeniable. “The 10-year risk of cardiovascular disease for a woman aged 72 years who had 2 cardiovascular risk factors, including hypertension and smoking, increased from 31% without pneumonia to 90% with pneumonia,” the authors wrote.
The likely culprit in such cases: systemic inflammation. Infection dials up the body’s immune response, generating inflammation that can cause plaque to rupture and create blockages that lead to heart attack and stroke. Patients tend to have high levels of inflammatory markers circulating in their blood stream long after recovering from infection.
More research is needed to pinpoint strategies for reducing the increased cardiac risks of infection. The authors of the European Journal of Preventive Cardiology study propose studying treatment with cholesterol-lowering statins as a possible way to reduce risk.
People who have been hospitalized with serious infections may wish to consider heightened surveillance through inflammation tests that probe the health of arteries and blood vessels. The Cleveland HeartLab offers an array of tests to give patients a fuller picture of their cardiovascular risks, whether or not they have traditional heart disease risk factors like high cholesterol levels, high blood pressure, or a smoking habit.
As with flu, vaccination may help to lower the risk for pneumonia—and avoid related cardiovascular woes in the first place. Currently the CDC recommends pneumococcal polysaccharide vaccination for all adults 65 years or older, people ages 2 to 64 with certain medical conditions, and adults 19 to 64 who smoke cigarettes. Such steps can pay significant dividends for patients’ hearts and their health. With the current flu season reaching near epidemic status, it’s not too late to get a flu shot to ward off flu and lower your risk of heart attack and stroke, too!