Flu Virus Can Raise Risk of Heart Attack Among Heart Patients

The common flu virus may raise the risk of dying from heart disease by increasing the likelihood for heart patients to suffer a heart attack. Those who have diabetes or other risk factors may also be at greater risk.

Results of an analysis conducted by a group of British researchers of 39 previous studies of heart patients conducted between 1932 and 2008 showed an increase in the number of deaths from heart disease, as well as the occurrence of more heart attacks during flu season. In fact, the increased death rate averaged from 35 percent to 50 percent. The report was recently published in the journal Lancet.

Although currently only about one-third of Americans who suffer from heart disease receive flu vaccines, experts are urging all heart patients to get vaccinated against regular flu as well as swine flu. With more flu virus expected to be circulating this flu season, the possibility of experiencing flu-related medical issues is greater among those having heart-related problems. Dr. Ralph Brindis, vice president of the American College of Cardiology, says, “If we can convince cardiac patients to get a flu vaccine, that could ultimately save lives.”

Because flu viruses cause inflammation in the body, and most commonly in the lungs, heart patients who contract the flu become more vulnerable to complications including pneumonia and other types of infection. In addition, flu viruses can cause swelling in the heart or coronary arteries, potentially triggering the breaking off of dangerous clots that lead to a heart attack.

According to study author Andrew Hayward, a senior lecturer in infectious disease epidemiology at the University College London Centre for Infectious Disease Epidemiology, “We know influenza vaccine is effective in preventing influenza and therefore in theory, ought to be effective in preventing the complications of influenza.” Hayward pointed out that two of the studies in the analysis indicated that heart patients who received a flu vaccine suffered fewer heart attacks than those who did not. He also acknowledged that “Influenza may be bringing forward an event that might have happened anyway,” and further explained that some evidence suggests that heart attacks peak when the flu virus does.

It remains unclear as to whether the new study results can be applied to people who are otherwise healthy, with no history of heart disease. However, the researchers noted that flu viruses could potentially trigger heart attacks among people having risk factors such as high blood pressure or those who are overweight. Diabetes is another condition that may put individuals at greater risk.

The researchers concluded, “We believe influenza vaccination should be encouraged wherever indicated, especially in those people with existing cardiovascular disease. Further evidence is needed on the effectiveness of influenza vaccines to reduce the risk of cardiac events in people without established vascular disease.”

The Advisory Committee on Immunization Practices (ACIP), selected by the Secretary of the U. S. Department of Health and Human Services, recommends annual flu vaccines for all people who are at high risk of having serious seasonal flu-related complications or people who live with or care for those at high risk for serious seasonal flu-related complications. According to the American Heart Association, about 36,000 people die each year from flu, while over 200,000 are hospitalized due to complications arising from it including bacterial pneumonia, dehydration and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes.

Smoking Bans Cut Heart Attack Risk

Every year, more than 400,000 Americans die of illnesses related to their smoking, and so do thousands of non-smokers who have been exposed to secondhand smoke—a combination of smoke that comes from the burning end of a cigarette, cigar or pipe and the smoke exhaled by the smoker. Non-smokers who breathe in secondhand smoke take in the same toxic chemicals that smokers do, including more than 50 substances that are known to cause cancer in humans or animals. The more secondhand smoke a person is exposed to, the higher the level of these harmful chemicals in their body. For adults, the health effects of exposure to secondhand smoke include respiratory tract infections, lung cancer, nasal sinus cancer and heart disease.

In 1971, the Surgeon General proposed a federal smoking ban in public places and released a report the next year declaring secondhand smoke a health risk. In 1973, Arizona became the first state to restrict smoking in public places and today, 24 states have enacted statewide bans on smoking in all enclosed public places, including bars and restaurants. And experts say these bans are really paying off.

After analyzing a number of recent studies on the effects of smoking bans, investigators at the U.S. Institute of Medicine (IOM) concluded that smoke-free policies can reduce the risk of heart attack by up to 47 percent and significantly reduce the likelihood of other heart problems. They also found evidence that even a brief exposure to secondhand smoke can trigger a heart attack. “We did conclude a cause-and-effect relationship exists between heart disease and secondhand smoke exposure,” said Dr. Lynn R. Goldman, a professor of environmental health sciences at Johns Hopkins Bloomberg School of Public Health and chairwoman of the IOM committee. She noted that sufficient evidence also exists to support a cause-and-effect relationship “between exposure to secondhand smoke and heart attacks or acute coronary events.”

The committee’s findings echo those of the Surgeon General in 2006. His report also concluded that secondhand smoke causes premature death and disease in children and nonsmoking adults and declared that the only way to fully protect non-smokers from exposure to secondhand smoke indoors is to prevent all smoking in that indoor space or building. Separating smokers from non-smokers, cleaning the air, and ventilating buildings cannot keep non-smokers from being exposed to secondhand smoke. Unfortunately, as of June 2009, 27 states still did not have comprehensive smoking bans in place; meaning that one in four U.S. indoor workers is still not protected by a complete smoke-free workplace policy and nearly three in five Americans do not live under comprehensive state or local laws that make workplaces, restaurants, and bars smoke-free, according to the CDC.

Danny McGoldrick, vice president for research at Campaign for Tobacco-Free Kids, hopes this new report will help get more states and localities to pass smoke-free legislation. “If policy makers are paying attention to the science, and this is one more piece of evidence that says ‘you can actually save people’s lives, save health-care costs,’ then those states that have yet to act should do so,” he said. “How many dramatic findings do you need before you are finally going to act to protect everybody’s right to breathe clean air?”

Until the time everyone is protected against secondhand smoke, there are important steps you can take to lower your risk and protect your family from exposure. The CDC suggests the following:

Don’t smoke or allow smoking indoors or in a vehicle, at anytime.
Visit only those restaurants and businesses that are 100 percent smoke-free. Separate “no smoking” sections DO NOT completely protect you from secondhand smoke. Neither does filtering the air or opening a window.
Take special precautions to ensure that family members who have heart disease or risk factors for heart disease avoid secondhand smoke exposure.
Encourage your community leaders to implement policies that make all indoor workplaces and public places, including restaurants, bars, and casinos, smoke-free.