What people with heart disease should know about vaccines today
By Michael Merschel, American Heart Association News
In some ways, the link between viruses, vaccines and heart health is simple.
Think of your heart as a house, said Dr. Jorge Alvarez是圣安东尼奥卫理公会心脏病诊所的介入心脏病专家. "You have the walls of your house, which are like the walls of your heart. You have the doors, which are the valves. And then you have plumbing and electricity.
"A virus can affect all of those aspects of your house," he said.
That makes being vaccinated against COVID-19, 流感和其他疾病是心脏病患者保护自己的重要方式.
That fact can get lost in the swirl of new information, not to mention misinformation, surrounding vaccines. Now that the updated COVID-19 vaccine 是否可以获得-并且可以与流感疫苗同时接种-以下是专家关于心血管疾病患者应该了解哪些病毒和疫苗的更直接的答案.
Viruses pose serious heart risks
Heart issues and infection are linked in many ways. One is inflammation, said Dr. 加州大学旧金山分校心脏病学助理教授Saate Shakil说.
Diseases caused by viruses, such as the coronavirus, influenza and respiratory syncytial virus, or RSV, can cause inflammation. So can bacterial illnesses such as pneumonia.
如果你有冠心病，血液流动会受到充满斑块的动脉的限制. In such cases, inflammation could lead to a plaque rupture, blood clot and blocked artery that causes a heart attack or stroke, said Shakil, who has studied links between COVID-19 and stroke.
Other research has shown:
-约20%因呼吸道合胞病毒住院的成年人出现心脏病发作和心力衰竭(心脏不能正常泵血)等问题, according to a 2018 study in the Journal of the American College of Cardiology.
– COVID-19 is linked to an increased risk of irregular heartbeats, heart failure and coronary disease. In a study published in 2021 in The Lancet, COVID-19与心脏病发作风险增加3至8倍、中风风险增加3至7倍相关.
– The risk of a heart attack may be as much as six times higher in the week after a flu diagnosis, found a study published in 2018 in the New England Journal of Medicine.
A virus doesn't have to attack the heart directly to endanger it, Shakil said. Someone with pneumonia might have trouble breathing, which strains the heart.
Meanwhile, Alvarez said, 感染引起的高烧有时会导致某些人出现心律问题.
Vaccines protect against those risks
Alvarez likens cardiovascular problems to a campfire. 在他的比喻中，导致动脉斑块的胆固醇就像一堆越来越多的木头. Inflammation is the lighter fluid. A viral or bacterial infection is the match that sets it all off.
他说，疫苗就像一桶水，可以阻止整个过程.
A research letter published in February in JACC found that among more than 1.9 million people infected with the coronavirus, vaccination was associated with a lower risk of heart attacks, strokes and other cardiovascular events.
Flu vaccination, meanwhile, is associated with a lower risk of stroke. In an analysis published in the Journal of the American Heart Association in 2021, 接种流感疫苗还能将心血管疾病导致的死亡几率降低18%，将任何原因导致的死亡几率降低25%.
The Centers for Disease Control and Prevention 患有心脏病或中风的人应该与他们的医疗团队讨论COVID-19疫苗接种, flu and pneumococcal disease, which includes pneumonia and meningitis. They should also stay current on a Tdap vaccine, which protects against diphtheria, tetanus and pertussis (also known as whooping cough).
The CDC also recommends that adults 60 and older ask about the new RSV vaccine.
A health care professional can offer advice on other vaccines, as well as whether to avoid certain formulations. For example, the CDC says people who are pregnant, 免疫系统较弱或50岁及以上的人不应接种鼻喷流感疫苗, which is a live virus-based vaccine. "It's not that they can't get vaccinated," Shakil said. "It's just that the type of vaccine has to be tailored for them."
Vaccination risks are real – but far outweighed by the benefits
Vaccines can have side effects. The COVID-19 vaccine, for example, has been linked to rare cases of myocarditis and pericarditis, types of heart inflammation.
That has to be viewed in context, said Dr. Gregory Piazza是波士顿布莱根妇女医院血管医学主任.
“我们所谈论的疫苗风险是非常罕见的沙巴体育平台点击进入," said Piazza, who also is an associate professor of medicine at Harvard Medical School. 通过降低COVID-19的严重程度和降低住院或患心血管并发症的几率，“你会得到很大程度的好处”.
"Those are real, tangible benefits," he said.
Piazza, who designed and oversees a large nationwide study of COVID-19 patients, said the scope of serious side effects is "very small. Very, very small." For example, some vaccinated people had issues with blood clots.
“但许多人如果因为COVID-19住院，就会出现血栓问题," Piazza said. A study 2022年发表在《沙巴足球体育平台》杂志上的一项研究发现，1万多名英国人有10500多例危险血栓.4 million COVID-19 patients than would be expected without COVID-19.
When Alvarez's patients express concerns about vaccine risks, 他指出，他们在去他办公室的路上发生重大车祸的风险——这是他们都能接受的风险——高于对疫苗产生严重反应的风险.
"Vaccines are safe and effective, and they help save lives," he said.
Shakil said her patients often have asked about vaccine safety, so she examined the history of each patient for risks. "I see a lot of patients, 我不认为有一个病人在我们看了他们的数据后觉得接种疫苗对他们来说是有风险的. If anything, 他们感染COVID而没有接种疫苗的风险更大."
Vaccines aren't perfect
尽管总体上有好处，但COVID-19和流感疫苗并不能阻止所有感染. That does not mean they didn't work, Alvarez said.
他把疫苗比作帮助你的免疫系统为考试做准备——它可能不会得到100%的分数, but it's going to do a lot better than someone who didn't study at all.
You don't have to sort this out alone
Worried or confused about which vaccines you need? It's OK to grill your cardiologist or primary care physician, Alvarez said.
Ask them to explain their reasoning, then be open-minded about what they say. “在这些事情背后应该有一些思考和讨论，”他说.
There are no silly questions, Shakil said. “可能发生的最糟糕的事情是，你离开时获得的信息比进来时还多."
要查找提供COVID-19和流感疫苗的地点，请访问联邦网站 vaccines.gov or call 800-232-0233.