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Lower your heart attack and stroke risk with a flu shot

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If you’ve had a heart attack, an annual influenza vaccine may cut your risk of another heart attack in half.

Peak flu season is looming, so get your vaccination soon.

If you didn’t get a flu shot last fall, it’s not too late to roll up your sleeve. If you need extra incentive, consider this: a new study suggests that getting an influenza vaccination lowers your odds of a having a heart attack, a stroke, heart failure, or another major cardiac event—including death—by about a third over the following year.

What’s the connection between flu and cardiovascular problems? “When you get the flu, your body mounts an impressive immune response, which causes a lot of inflammation. As a result, the plaque inside your blood vessels can become unstable, which can lead to blockage and a possible heart attack or stroke,” says lead author Dr. Jacob Udell, who trained in cardiology at Harvard-affiliated Brigham and Women’s Hospital and is now a cardiologist at Women’s College Hospital in Toronto.

Meanwhile, changes in the lungs wrought by the flu virus can lower blood oxygen levels, which makes the heart work harder. The virus can also directly injure heart muscle cells, leading to heart failure or making it worse.

Recent heart attack survivors benefit most

The study, which appeared in The Journal of the American Medical Association, pooled data from six clinical trials involving more than 6,700 people. Their average age was 67. About one-third had heart disease; the rest did not. Over all, those who were vaccinated against the flu had a 36%
lower risk of a having major cardiac event during the following year. And for those who had
recently had a heart attack, a flu shot cut the risk of heart attack or stroke even further.

Dr. Udell cautions that his findings still need to be confirmed with a large clinical trial, which he’s currently planning. If the findings hold true, “we may be able to tell patients that getting your flu shot might save your life—what a simple and significant way to reduce deaths and the burden on our health care system,” says Dr. Udell.

Experts recommend a flu shot for everyone 6 months of age and older. It is especially important for those who face the highest risk of complications: young children; adults over age 50; those of all ages with serious health conditions such as cardiovascular disease, asthma or other lung disease, liver or kidney disease, or diabetes; and those who care for young children or other people at high risk of flu complications.

Small effort, big gain

Yet more than half of people younger than 65 with serious health conditions skip an annual flu shot, as do about a third of all people older than 65. Compared with other heart-healthy habits like exercise and healthy eating, getting a yearly flu shot is pretty low effort. Ideally, it’s best to get vaccinated before the virus-swapping season around the holidays, but January isn’t too late, experts say. Most years, influenza activity peaks in February, although the disease can occur as late as May.

High-dose vaccine: Worth a shot?

The immune response wanes with age, which is why older people face a greater risk
of serious illness from influenza. Fluzone, a high-dose influenza vaccine approved for people ages 65 and older, contains four times the amount of antigen (the part of the vaccine that prompts your body to make flu-fighting antibodies) used in regular flu shots. But while clinical trials show the high-dose vaccine generates a stronger immune response, there’s no proof it actually leads to fewer cases of the flu, says Dr. Kelly Ford, assistant professor of medicine and internist at Harvard-affiliated Beth Israel Deaconess Medical Center. “We don’t stock the vaccine at our hospital,” says Dr. Ford. “The high-dose shot costs $20 more per dose, and it’s not clear that we should spend money on a vaccine that has no proven additional benefit.”

A study to answer that question is under way, with results expected in 2014 or 2015. For most people, however, cost isn’t an issue because Medicare covers both types, provided it’s available from your doctor, local pharmacy, or elsewhere in your community. If it’s not, don’t worry: The most important thing is to get vaccinated.

Posted by: Dr.Health

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