Heart Attack Prevention: Another Good Reason to Get a Flu Shot?

by Richard O’Boyle, Publisher
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Most people aged 65 and older are advised to get a flu shot each fall to stave off the debilitating aches, fever, and chills of the flu during the winter months. But now researchers think they have found an additional benefit to an annual flu shot: prevention of a heart attack in people who have existing heart problems.

“We found that getting a flu shot was associated with a 67% reduction in the risk of having a second heart attack for those over the age of 65,” says S. Ward Casscells M.D., director of the University of Texas-Houston Medical School Department of Internal Medicine Division of Cardiology. “This benefit was confirmed by a similar study done in Washington State.”

Numerous studies have suggested that microbial agents may promote the buildup of plaques in the arteries that lead to heart attacks. A smaller body of research suggests that respiratory infections may also raise a person’s risk for a heart attack. Dr. Casscells and other researchers at the University of Texas studied a small sampling of patients during the 1997-1998 flu season with a documented history of a heart attacks and flu vaccination. Details of the study were published in 2000 in the American Heart Association’s journal Circulation.

Researchers aren’t exactly sure why the flu shot seems to work to prevent second heart attacks, but lead author Morteza Naghavi suggested that general inflammation caused by the flu might cause unstable plaque to develop a clot and block the artery. Doctors first suggested a possible link between the flu and heart attacks as far back as the early 1900s when flu epidemics killed millions in Europe and America.

Naghavi notes that additional work is needed to confirm the cause and effect relationship between flu vaccination and cardiovascular protection. The researchers say that the behavior of some patients, rather than the flu vaccine itself, may help to reduce their risk of having a heart attack while sick with the flu. For example, resting, eating less (including foods high in sugar and fat), cessation of cigarette smoking, and an increased use of aspirin may contribute to the lower heart attack risk. On the other hand, patients who take large amounts of nonsteroidal anti-inflammatory drugs or decongestants, which raise their blood pressure, may put them at higher risk of a heart attack.

High cholesterol, hypertension, smoking, diabetes, physical inactivity, and obesity are among the modifiable risk factors for a heart attack, according to the American Heart Association. Yet other risks can be associated with heart attacks as well, including general inflammation and hereditary conditions.

Winter is an especially risky time for people with heart disease, Dr. Robert Kloner, who directs research at the Heart Institute at Good Samaritan Hospital in Los Angeles. His research, which was presented on March 12, 2000 at the American College of Cardiology Annual Scientific Session in Anaheim, California showed that the size of a heart attack was one-third larger during winter and spring than during other seasons. The reason for the increased risk in winter is unclear, but the researchers said it may be related to an increase in risk factors, such as body weight and blood pressure; inflammation of the walls of arteries as a result of infection; the response of the cardiovascular system to the cold; or exertion from such activities as snow shoveling.

The Flu

Influenza, commonly call “the flu,” is a contagious disease that is caused by a virus that attacks the nose, throat, and lungs. The flu is spread when an infected person coughs, sneezes, or speaks and sends flu virus into the air, and other people inhale the virus. Flu may, less often, be spread when a person touches a surface that has flu viruses on it – a door handle, for instance – and then touches his or her nose or mouth. It’s a good idea to steer clear of people who have the flu or recently got over an infection. It also makes sense to keep your hands clean.

According to the National Institutes of Health, 35 to 50 million Americans come down with the flu during each flu season, which typically lasts from November to March. The fever, exhaustion, and aches and pains of the flu can be debilitating for a week or two, but for the elderly and those with compromised immune systems, the flu can be much more serious. An estimated 115,000 hospitalizations and about 20,000 deaths occur each year from the flu or its complications.

The best way to prevent the flu is to get an influenza vaccine (“flu shot”) in October before the virus begins to spread through communities, according to the Advisory Committee on Immunization Practices. Individuals who work with or care for the elderly and those with chronic medical conditions should also get vaccinated. Certain individuals who have extreme allergies to eggs or other components of the vaccine should not be vaccinated. A flu shot should be given each and every year since the strains of the disease change and the potency wears off.

Your doctor, nursing home medical director, or community organization such as pharmacy or senior center, will be able to arrange for you to get a flu shot. Medicare pays for flu shots for people aged 65 and older.

Related Articles:

 - “Influenza and Pneumonia in Older Adults” http://www.ec-online.net/Knowledge/Articles/flu.html
 - “High Blood Pressure in Older People” http://www.ec-online.net/Knowledge/Articles/bloodpressure.html
 - “Tips on Quitting Smoking” http://www.ec-online.net/Knowledge/Articles/quitsmoking.html
 - “You and Your Doctor: It Takes Two to Tango” http://www.ec-online.net/Knowledge/Articles/twototango.html


 - “Can Flu Shots Also Prevent Heart Attacks?” by Shannon Rasp, UT Health Science Center at Houston, Public Affairs, http://www.utcardiovascular.com/Hnews/H-Stor07.htm
 - “Association of Influenza Vaccination and Reduced Risk of Recurrent Myocardial Infarction,” Morteza Naghavi, MD, et al. “Circulation,” 2000; 102: 3039 http://circ.ahajournals.org
 - “Risk of Heart Problems Climbs During Winter Months,” American College of Cardiology Foundation, http://www.acc.org/media/session_info/newsconf/sundayhigh.htm
- “Winter Maladies: Influenza and Pneumonia in Older Adults” by Richard O’Boyle http://www.ec-online.net/Knowledge/Articles/flu.html
 - “Focus on the Flu” National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/newsroom/focuson/flu00/default.htm
 - American Heart Association http://www.americanheart.org
 - “Flu in the United States” Centers for Disease Control and Prevention http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm
 - “Prevention and Control of Influenza” Recommendations of the Advisory Committee on Immunization Practices http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5103a1.htm
 - “Health Information: Flu and Pneumonia” Centers for Medicare and Medicaid Services http://www.medicare.gov/health/flu.asp


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