CARDIOLOGY
Heart research findings: risk and prevention
ESC Congress is the world’s largest gathering of cardiovascular professionals contributing to global awareness of the latest clinical trials and breakthrough discoveries. Clinical Services Journal provides an overview of some of the key findings around risk and prevention, presented at this year’s digital event.
From the role of vaccinations and gut health in improving outcomes, to new insights into the link between teenage depression and mid-life heart attack, this year’s digital conference highlighted the latest research findings on risk factors and prevention. High on the agenda were the findings of a study of nearly three-million Americans which showed that influenza and pneumonia vaccinations have a positive impact on reducing deaths from heart failure.1 One out of five individuals will develop heart failure in their lifetime. An estimated 26 million people are affected worldwide.2
Heart failure is a serious
condition in which the heart cannot pump blood around the body as well at it should. It leads to a build-up of fluid in the lungs, causing shortness of breath and coughing, and impacts people’s quality of life, often requiring urgent hospitalisations. Respiratory
infections such as influenza and pneumonia make heart failure worse, and annual vaccinations are recommended. “The COVID-19 pandemic has shone the spotlight on the importance of vaccination to prevent respiratory infections, particularly for people with diseases like heart failure,” said study author Dr. Karthik Gonuguntla of the University of Connecticut.
While it is known that inoculations protect against respiratory infections, and that these infections exacerbate heart failure, few studies have compared outcomes of vaccinated versus unvaccinated patients. This study examined whether immunisations had any link with the risk of heart failure patients dying while in hospital. The study included 2,912,137 patients
with heart failure who had a hospital admission in 2010 to 2014. The average age was 70 years. Data were obtained from
the National Inpatient Sample (NIS), which covers more than 95% of the US population. Just 1.4% of patients in the study had the flu vaccine and 1.4% had the pneumonia vaccine. The researchers compared in- hospital death rates between heart failure patients who received flu and pneumonia vaccinations that year and those who did not. Rates of in-hospital mortality were significantly lower in patients who received the flu vaccine (1.3%) compared to those who did not receive the flu vaccine (3.6%). Similarly, rates of in-hospital mortality were significantly lower in patients inoculated against pneumonia (1.2%) compared to those who were not inoculated (3.6%). Dr. Gonuguntla said: “Our study provides
further impetus for annual immunisations in patients with heart failure. Despite advice to do so, uptake remains low. Although large administrative databases like the NIS are prone to containing some errors, the data indicate that there is some distance to go before reaching 100% coverage.” He noted that serious reactions to flu and pneumonia vaccinations are very rare, happen within a few hours, and can be effectively treated. Dr. Gonuguntla said: “Pneumonia and flu vaccines are vital to preventing these respiratory infections and protecting patients with heart failure. Although many people have rejected common and safe vaccines before COVID-19, I am optimistic that the pandemic has changed perceptions about the role of immunisations in safeguarding our health.”
Gut health
The Congress also offered new insights into risk factors and prevention for conditions such as hypertension. Research presented showed that bacteria and other microorganisms in the digestive tract are linked with dozens of health conditions including high blood pressure, high blood lipids, and body mass index (BMI).3,1
NOVEMBER 2020
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