Flu Vaccine 2018 - 2019
Flu Shot May Save Heart Failure Patients’ Lives
Study finds immunization slashes risk of death in half during flu season.
By Becky Upham
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March 6, 2019
New research finds that the seasonal influenza vaccine significantly reduces the risk of death among heart failure patients.
The flu and potential complications such as pneumonia pose special problems for people with heart disease. According to the American Heart Association, 6.5 million U.S. adults are living with heart failure, a chronic condition in which the heart becomes too weak to adequately pump blood.
Researchers at the Nagoya City University Graduate School of Medical Sciences in Nagoya, Japan, analyzed six studies conducted in the United States, Europe, and Asia that included data for more than 78,000 heart failure patients. The study found that getting a flu shot was associated with a 50 percent drop in the risk of death during flu season and a 20 percent drop during the rest of the year.
“It is well known that influenza infection is associated with increased risk for mortality in heart failure patients,” says Hidekatsu Fukuta, MD, a cardiologist and the study's lead author. “Given the high mortality rate and the relatively low influenza vaccination rates in heart failure patients worldwide, our study supports a wider use of influenza vaccination in heart failure patients.”
Dr. Fukuta will present the study, “The Effect of Influenza Vaccination on Mortality and Hospitalization in Patients With Heart Failure: A Meta-Analysis,” on March 11 at the American College of Cardiology's 67th Annual Scientific Session in Orlando, Florida.
A ‘Surprising’ Degree of Reductions
“I am not surprised that there were reductions in mortality,” says Kristine Owen, MD, an interventional cardiologist and the director of the cardiac catheterization lab at the Charles George VA Medical Center in Asheville, North Carolina. “But the degree of the reductions was somewhat surprising.”
Dr. Owen, who was not involved in the study, agrees with Fukuta’s assertion that there are more heart events during flu season. “The heart and the lungs are inherently connected,” she says. “Anything that strains the lungs will also increase the workload of the heart.”
Owen recommends the vaccine to all her patients. “I explain to them that the flu vaccine does not help their heart in a direct, traditional sense, but that influenza itself is just so hard on the heart that preventing infection is the goal,” she says.
Similar Findings on Flu and the Heart
Other recent research further illustrates the danger that influenza can pose to the heart. A study published January 25, 2019, in theNew England Journal of Medicinefound that the risk for a heart attack was six times greater in the week after contracting the flu.
William Schaffner, MD, a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee, is not surprised by both studies’ findings. “The inflammation that the flu causes throughout our body also affects the blood vessels that go to the heart,” he says.
Dr. Schaffner is skeptical, however, that the flu shot has year-round heart-health benefits beyond protection against influenza. “The vaccination would not confer benefits beyond the flu season,” he says. “One explanation for the reduced risk could be that a segment of the subjects are healthier or more health-interested year-round.”
“I would hypothesize that the year-round mortality benefit would be due to the overall preserved health of the heart and the prevention of strain on the body’s other organ systems,” Owen adds.
Fukuta agrees that more research is needed. “Large-scale and adequately powered randomized controlled trials should be planned to confirm our observed potential survival benefit of influenza vaccination in heart failure patients,” he says.
Revised Guidelines for Heart Failure Patients?
Patient guidelines from the Heart Failure Society of America include an annual flu vaccine. While the American College of Cardiology (ACC) also recommends a flu shot every year for cardiovascular disease patients, it does not specifically address people with heart failure.
Owen thinks that may change. “With all of the recently released data showing significant mortality benefits, I would expect the ACC to modify their guidelines to recommend prophylactic influenza vaccines in heart failure patients,” she says.
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