Common Viruses Linked to Dramatic Increase in Risk of Heart Attacks and Strokes

Certain viruses could make people more susceptible to heart disease, new research suggests.

An independent study showed that people who contracted COVID or influenza faced a “dramatically” increased risk of having a heart attack or stroke (up to three to five times greater) in the weeks after infection.

Researchers reviewed 155 scientific studies to come up with these findings, which were published this week in the Journal of the American Heart Association.

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“It is well known that human papillomavirus (HPV), hepatitis B virus, and other viruses can cause cancer; however, the link between viral infections and other noncommunicable diseases, such as cardiovascular disease, is less understood,” said Kosuke Kawai, senior author of the study and adjunct associate professor at the David Geffen School of Medicine at the University of California, Los Angeles.

“Our study found that acute and chronic viral infections are linked to short- and long-term risks of cardiovascular disease, including strokes and heart attacks.”

Researchers found that people are four times more likely to have a heart attack and five times more likely to have a stroke in the month after a positive flu test, according to an AHA news release.

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In the 14 weeks after contracting COVID, people were three times more likely to have a heart attack or stroke, and were at elevated risk for up to a year.

The role of inflammation

When the body fights a virus, the immune system releases chemicals that cause inflammation and make the blood more likely to clot, the statement said.

Sometimes these effects can persist even after the person has recovered from the infection. Continued inflammation and clotting can put additional pressure on the heart and contribute to plaque buildup in the arteries, which may help explain why some people face a higher risk of heart attacks or strokes in the coming weeks.

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“The findings suggest that low-grade inflammation plays a role by increasing the activation of blood clotting and damaging the inner lining of the arteries, which supply blood to our body,” said Dr. Bradley Serwer, interventional cardiologist and chief medical officer of VitalSolution, an Ingenovis Health company that provides cardiovascular and anesthesiology services to hospitals nationwide.

“While we knew of a link between inflammation and cardiovascular events, this study showed that many common viruses have a greater impact than we thought,” added Maryland-based Serwer, who was not involved in the study.

Markers of inflammation called C-reactive protein (CRP) are known to be associated with an increased risk of cardiac events, the expert said.

Inflammation can damage arteries in several different ways, including causing microscopic tears that allow “bad cholesterol” (LDL) to invade and form plaque.

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“Increased inflammation can destabilize these plaques, causing them to rupture, thus leading to a heart attack or stroke,” Serwer said. “Inflammation also triggers the clotting process by activating platelets.”

Risk of chronic infection

The study found that some chronic viruses, such as HIV, hepatitis C, and varicella zoster virus (the virus that causes shingles), were linked to long-term cardiovascular risk.

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Those with HIV were found to have a 60% increased risk of having a heart attack and a 45% increased risk of having a stroke. Among people with hepatitis C, there was a 27% increased risk of having a heart attack and a 23% increased risk of having a stroke. Shingles increased the risk of heart attack by 12 percent and the risk of stroke by 18 percent, the study found.

“The elevated risks of cardiovascular disease are lower for HIV, hepatitis C, and shingles than the increased short-term risk following influenza and COVID; however, the risks associated with those three viruses remain clinically relevant, especially as they persist over a long period of time,” Kawai said in the statement.

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“In addition, shingles affects approximately one in three people during their lifetime. Therefore, the high risk associated with this virus translates into a large number of excess cases of cardiovascular disease at the population level.”

Reduce risk

Researchers recommended vaccination against influenza, COVID and shingles, citing studies linking a lower risk among those who received the flu vaccine.

“Preventive measures against viral infections, including vaccination, can play an important role in reducing the risk of cardiovascular disease. Prevention is especially important for adults who already have cardiovascular disease or… risk factors,” Kawai said.

Serwer agrees that vaccination against many of these common viruses is a “key preventative strategy.”

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The researchers acknowledged some limitations of the study, including the fact that it was based on observational studies and not randomized controlled trials.

“Because most studies examined infection with a single virus, it is unclear how infection with multiple viruses or bacteria may have affected the results,” the statement states.

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“The analysis focused on viral infections affecting the general public and did not identify high-risk groups (such as transplant recipients) who may be disproportionately affected.”

For people with cardiovascular disease, the researchers recommended consulting a doctor to discuss vaccine recommendations.