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A sweeping new analysis confirms a concerning link between common viral infections – from influenza and COVID-19 to HIV and shingles – and an increased risk of cardiovascular disease, underscoring the critical importance of vaccination in safeguarding heart health.
Cardiovascular diseases (CVDs) remain the world’s leading cause of death, responsible for over 20 million fatalities in 2021 alone. A groundbreaking systematic review and meta-analysis, published in the Journal of the american Heart Association, synthesizes data from 155 studies to reveal the extent to which viral pathogens contribute to this global health crisis. Researchers found notable associations between several viruses and both coronary heart disease and stroke.
For decades, public health efforts have focused on traditional CVD risk factors like high blood pressure, cholesterol, smoking, and diet. however, the role of viral infections has often been underestimated. The COVID-19 pandemic dramatically highlighted this oversight, demonstrating how a viral invasion can trigger a cascade of inflammatory responses within the body.
“When a virus invades, the body mounts an intense inflammatory response,” explains the study, revealing a key mechanism driving the connection between infection and heart disease. This systemic inflammation damages the delicate lining of blood vessels – a condition known as endothelial dysfunction – and increases the likelihood of blood clot formation (hypercoagulable state).
Infections: Varying Degrees of Risk
The meta-analyses revealed that both acute and chronic viral infections elevate CVD risk. Laboratory-confirmed influenza, for example, was associated with a staggering 4-fold increase in the risk of acute myocardial infarction (MI), or heart attack, and a 5-fold increase in the risk of stroke within the first month of infection. The highest risk period was the first seven days, with MI risk surging over 7-fold, though it declined to 1.87-fold by days 8-14.
COVID-19 infections were linked to a 1.74-fold increased long-term risk of CHD and a 1.69-fold increased risk of stroke. SCCS studies confirmed an acute risk, showing a 3.35-fold increase in MI risk within the first 14 weeks.
Chronic infections posed a persistent threat. HIV infection was associated with a 60% higher risk of CHD and a 45% higher risk of stroke, and was the only virus with robust evidence for increased risk of heart failure (an 89% increase). Hepatitis C Virus (HCV) was linked to a 27% higher risk of CHD, a 23% higher risk of stroke, and a doubling of the risk of cardiovascular death. Shingles, a reactivation of the chickenpox virus, was associated with a 12% higher risk of CHD and an 18% higher risk of stroke, with stroke risk peaking 1-3 weeks post-infection.
Notably, the review found no positive association between hepatitis B virus and insufficient evidence for cytomegalovirus, despite a tentative link to cardiovascular death. .
The Power of Prevention: Vaccination as a Key Strategy
The study strongly suggests that preventing infections through measures like vaccination is a critical strategy for protecting cardiovascular health. Direct trial evidence supports a 34% CVD risk reduction with influenza vaccines, while herpes zoster vaccines show promising indirect potential.
“Vaccination emerged as a key preventive strategy,” the researchers concluded, emphasizing the need for further research in underrepresented regions and for understudied viruses. This research underscores the interconnectedness of infectious disease and cardiovascular health, offering a powerful argument for prioritizing preventative measures to reduce the global burden of heart disease and stroke.
Journal reference:
Source: Kawai, K., Muhere, C. F., Lemos, E. V., & Francis, J. M. (2025). Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta‐Analysis. Journal of the American Heart Association. DOI – 10.1161/jaha.125.042670
