Mounting evidence shows that respiratory infections can make heart failure worse and increase the risk of heart attack. There are an estimated 60 million people in the EU living with cardiovascular disease (CVD). If infected with influenza, they face a six-fold increase in the risk of having a heart attack and an eight-fold increase in the risk of stroke.
This has prompted a major professional cardiology body to publish an official call for patients to be vaccinated.
The European Society of Cardiology (ESC) says infections ‒ such as pneumonia, influenza, SARS-CoV-2 and RSV, among others ‒ can trigger serious illness, hospitalisation and, in some cases, death. The Society has published a Clinical Consensus Statement in the European Heart Journal highlighting the key role of vaccination in preventing cardiovascular events.
‘We have known for many years that influenza can increase the risk of major adverse cardiovascular events such as heart attacks and can exacerbate heart failure,’ said Professor Thomas F. Lüscher, ESC President.
‘More recently, evidence suggests that other respiratory infections are also associated with increased cardiovascular morbidity and mortality. The new publication describes how vaccinations not only prevent infections but also reduce the risk of cardiovascular events, particularly in susceptible individuals.’
The paper presents the data on the risk of cardiovascular complications following infections and describes the inflammatory mechanisms that may be responsible. It also summarises the beneficial effects of vaccines in reducing cardiovascular events following various viral and bacterial infections, particularly in at-risk patient groups.
Clinical practice guidelines from the ESC and from the American College of Cardiology (ACC)/American Heart Association (AHA) advocate for vaccination against influenza and other widespread infections in patients with chronic coronary syndromes (including coronary artery disease) and in those with heart failure.
‘Prevention is crucial for reducing the considerable burden of cardiovascular disease,’ Prof Lüscher said. ‘The totality of the evidence indicates that vaccinations should become a foundational pillar of preventive strategies alongside other established measures.’
As one in five people in Europe are infected with flu each year, this makes winter a risky time for people with heart issues.
EU heart plan highlights vaccination
The EU is expected to publish a new European Cardiovascular Health Plan on 16 December 2025. It highlights the importance of vaccination in preventing cardiovascular complications, noting that vaccine coverage among risk groups is ‘suboptimal’ in many European countries.
The long-awaited plan includes a Flagship initiative which commits to developing a European Council Recommendation to promote immunisation as a preventive measure for cardiovascular diseases, taking a lifelong approach.
This would, if agreed, commit EU health ministers to focusing on uptake among those at risk of cardiovascular disease. Governments would be required, by 2029, to report coverage data for flu and COVID-19 vaccines in individuals with chronic diseases.