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Health & Medicine for Senior Citizens
Flu Vaccine Seems to Offer Seniors Protection from
Heart Failure, Heart Attack
Researchers encourage confirmation of this low-cost,
annual, safe, easily administered, and well-tolerated therapy to reduce
cardiovascular risk up to 50% - see video in story
Oct. 22, 2013 - For senior citizens
needing a push to motivate them to get their annual flu
shot, a new study showing the influenza vaccination appears
to offer as much as 50 percent protection from major adverse cardiovascular
events, such as heart failure, stroke or hospitalization from heart
attack. And, those who seemed to receive the most benefit
were those with recent acute coronary syndrome (ACS), such
as heart attack of unstable angina.
"Hundreds of thousands of people die each year from cardiac
causes in North America," said Jacob A. Udell, M.D., M.P.H., F.R.C.P.C.,
of the University of Toronto. "While preventative care
involves lifestyle changes and taking your pills, now, we
may also be able to tell patients by getting your flu shot,
it might save your life what a simple and significant way
to reduce deaths and the burden on our healthcare system."
Several earlier epidemiological studies suggested a
strong relationship between influenza vaccination and a lower risk of
fatal and nonfatal cardiovascular events.
Among nontraditional cardiovascular risk factors,
there remains interest in a potential association between respiratory
tract infections, of which influenza and influenza-like illnesses are
common causes, and subsequent cardiovascular events, according to the
authors in explaining their research in the October 23 issue of JAMA.
Dr. Udell and colleagues conducted a
meta-analysis of all randomized clinical trials (RCTs) of
influenza vaccine that studied cardiovascular events as
efficacy or safety outcomes to determine if influenza
vaccination is associated with prevention of cardiovascular
The researchers identified five published and 1
unpublished RCTs of 6,735 patients (average age, 67 years;
51 percent women; 36 percent with a cardiac history; average
follow-up time, 7.9 months) that met inclusion criteria for
the study. Analyses were stratified by subgroups of patients
with and without a history of acute coronary syndrome (ACS)
within 1 year of randomization.
In the 5 published RCTs, 95 of 3,238 patients treated
with influenza vaccine (2.9 percent) developed a major
adverse cardiovascular event compared with 151 of 3,231
patients (4.7 percent) treated with placebo or control
within 1 year of follow-up, an absolute risk difference
favoring flu vaccine of 1.74 percent.
The addition of the
unpublished data did not materially change the results (2.9
percent influenza vaccine vs. 4.6 percent placebo or
In a subgroup analysis of 3 RCTs of patients with
pre-existing coronary artery disease (CAD), the risk of
major adverse cardiovascular events among patients with a
history of recent ACS was especially lower with vaccine
(10.3 percent influenza vaccine vs. 23.1 percent placebo or
control), an absolute-risk difference of 12.9 percent,
compared to patients with stable CAD (6.9 percent influenza
vaccine vs. 7.4 percent placebo or control). Results were
similar with the addition of unpublished data.
Within this global meta-analysis of RCTs that studied
patients with high cardiovascular risk, influenza
vaccination was associated with a lower risk of major
adverse cardiovascular events within 1 year. Influenza
vaccination was particularly associated with cardiovascular
prevention in patients with recent ACS.
"Future research with
an adequately powered multicenter trial to confirm the
efficacy of this low-cost, annual, safe, easily
administered, and well-tolerated therapy to reduce
cardiovascular risk beyond current therapies is warranted,
the authors conclude.
Note: Dr. Udell is supported by a Canadian
Institutes for Health Research and Canadian Foundation for
Womens Health postdoctoral research fellowship award.
Editorial: Influenza Vaccination in 2013-2014
Achieving 100 percent Participation
In an accompanying editorial, Kathleen M. Neuzil, M.D.,
M.P.H., of PATH, Seattle, discusses the importance of
improving influenza vaccination coverage.
There are proven ways to increase vaccination coverage,
including expanding access through nontraditional settings
(e.g., pharmacy, workplace, school venues), improving the
use of evidence-based practices at medical sites (e.g.,
standing orders, reminder or recall notification), and using
"One of the most consistent and
relevant findings of operational research is that
recommendation for vaccination from physicians and other
health care professionals is a strong predictor of vaccine
acceptance and receipt among patients. While few are in a
position to develop new influenza vaccines, all health care
practitioners can recommend influenza vaccine to their
patients. Doing so will help achieve the goal of 100 percent
vaccination for the 2013-2014 influenza season.
Note: Dr. Neuzil reports receiving grant
funding from the Bill & Melinda Gates Foundation and Centers
for Disease Control and Prevention.