Bangkok Post

Flu shot may help pre❖ent heart attacks

- ■ DR EVE GLAZIER & DR ELIZABETH KO UNIVERSAL FEATURES SYNDICATE Dr Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.

DEAR DOCTORS: I can’t stop thinking about what my doctor said when I got my flu shot last fall. I’m a 55-year-old man, and I have a history of high blood pressure. He said the flu shot will give me extra protection against having a heart attack. What is the connection?

DEAR READER: When we think about the possible complicati­ons of the flu, they typically include a sinus infection, ear infection or an escalation to bronchitis or pneumonia. But an emerging body of research now points to a link between infection with the influenza virus and an increased risk of having a heart attack or stroke. This connection has proven to be particular­ly strong in people living with hypertensi­on and heart disease, and in those who have previously had a heart attack. In 2018, a Canadian study published in the New England Journal Of Medicine found that the inflammati­on that occurs during a case of the flu can trigger a heart attack. In that study, the researcher­s analysed seven years of medical data collected from adults of all ages with confirmed cases of influenza who had been hospitalis­ed. They found that in the week following their diagnosis, patients were six times more likely to have a heart attack than in the year before their hospitalis­ation or the year after.

A separate study, conducted two years later by the US Centers for Disease Control and Prevention, looked at health data from 80,000 adults over the course of eight flu seasons. Each of them had confirmed flu cases that were severe enough to require hospitalis­ation. The data showed that 12% of the adults in the study had a heart attack or died of heart failure in the week after their flu diagnosis.

This year, researcher­s in Spain looked at the same question in adults 50 and older. In that population, even mild flu translated to a doubled risk of heart attack, and also stroke, in the two weeks following diagnosis. In patients with heart disease, the risk of heart attack, stroke or heart failure quadrupled.

As anyone who has experience­d the prolonged misery of the flu knows, it’s a serious infection. Inflammati­on causes a wide range of symptoms, including fever, cough, headache, sore throat, congestion, muscle aches and pains, and fatigue and exhaustion. Now researcher­s suspect that influenza infection may also have an adverse effect on arterial plaque. That’s the build-up of cholestero­l within the walls of the vessels that return blood back to the heart. It is thought that the widespread inflammati­on in an influenza infection can cause ruptures in existing plaques. This causes the formation of a blood clot, which then impedes or completely blocks blood flow and leads to a heart attack.

These studies bolster the existing guidance regarding the benefits of getting an annual flu shot. And while it’s already spring and time to think about sunblock, in many parts of the country, significan­t flu activity continues as late as May. Particular­ly for those at higher risk, it’s still not too late to get a flu shot.

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