Diabetes, Heart and Cardiovascular Diseases News Chronicle.  Diabetes, Cardiovascular and Heart Diseases
 Article 321
    Published on April 10, 2018

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Influenza, commonly known as the flu infection increases the risk of a heart attack

Acute respiratory infections may trigger severe heart attacks (also known as acute myocardial infarction MI). An earlier study had found that the influenza vaccination can reduce risks associated with cardiovascular diseases and mortality due to the flu or influenza infection. But the protection offered by the vaccines in elder people may not be as effective as in younger people as immunity strength reduces with age. That study had supported existing international guidelines advocating the flu shots (also known as influenza vaccines or flu jabs) to high risk to heart attack individuals affected with flu or influenza infection.

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People who are at high risk for the development of flu-related complications are.

  • Older people aged more than 65 years.
  • Children or kids aged less than five years.
  • Healthcare professional and other people working in nursing homes.

There are heart attack events even in young people affected by flu or influenza. As heart attack events are exceedingly rare among younger people aged less than 35 years, researchers suggest a link between flu infection and heart attack.

Researchers wanted to find out the association between acute myocardial infarction MI (or heart attack) and laboratory-confirmed influenza infection. In a first study showing the quantum of heart attack risk with influenza, a Canadian self-controlled case-series design study shows six times increased risk of severe heart attack among individuals during the first seven days of laboratory-confirmed flu or influenza infection when compared to a risk of a heart attack one year before or after.

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Researchers have conducted analytical studies among about 20,000 adult heart attack patients from Ontario, Canada from 2009 to 2014, aged more than 35 years. They were with laboratory-confirmed influenza infection one year before. Health records show

  • About 332 individuals were hospitalized with heart attack events.
  • About one-third of them died due to a heart attack.
  • About 75 percent of them were aged more than 65 years with an average age of 77 years.
  • About 50 percent of them were women.
  • About 25 percent of them were with heart attack history and were hospitalized. Most of them are with heart attacks risk factors such as high blood pressure, high blood sugar glucose (type 2 diabetes T2D) and high cholesterol levels.
  • About one-third of them had flu shots.
  • About 31 percent of the patients were not vaccinated against seasonal flu.
  • They also observed no heart attack events after seven days of laboratory-confirmed flu infection.
  • Further analysis found that 20 patients had a heart attack within a week of their laboratory-confirmed flu infection.

The analytical study results show.

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  • Flu affected individuals aged more than 65 years are at higher risk of heart attack when compared to lower age individuals.
  • Infection caused due to influenza B strain causes more heart attack events when compared with heart attack events with the flu caused due to influenza A strain.
  • Other common respiratory viruses such as human respiratory syncytial virus (RSV or HRSV), human parainfluenza viruses (HPIVs) or respiratory adenoviruses too causes enhanced risk of heart attack, but to lesser extent.
  • The study results show no risk of heart attack on day eight and beyond.
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Authors say influenza infections may lower blood pressure causing a lower amount of oxygen in the blood. The heart pumps blood faster to compensate lower oxygen levels in the blood causing heart attacks among those people with early heart disease.

Infection also causes inflammation in the arteries. There are enhanced heart attack risks with the inflammation due to the formation of blood clots in the arteries supplying blood to heart and heart tissues.

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This study results also show a possible immediate heart attack risk within seven days with laboratory-confirmed influenza infection. Authors say patients with acute respiratory infection should take flu shots immediately.

Researchers say those sick individuals affected with the flu should take precautions with measures such as washing their hands regularly, staying at home, taking flu shots (also known as influenza vaccines or flu jabs) and prevent the spreading of respiratory infections and influenza.

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The study was funded by following organizations.

  • Canadian Institutes of Health Research (CIHR), a federal funding agency for health research in Canada.
  • International Council for the Exploration of the Sea (ICES), Copenhagen, Denmark.
  • Public Health Ontario (PHO), Canada.

Six times the increased risk of a severe heart attack during the first 7 days of the flu or influenza infection.
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Lead author of the study was Dr. Jeffrey C. Kwong, MD, MSc, CCFP, FRCPC, senior core scientist, Primary Care & Population Health Research Program, Institute for Clinical Evaluative Sciences (ICES), Toronto, Canada. The study findings were published January 25, 2018, in the New England Journal of Medicine. Title of the article was "Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection." DOI : dx.doi.org/10.1056/NEJMoa1702090

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