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Unless you’ve had the flu recently enough that the sheer misery is fresh in your mind, you might think it’s not that big a deal. But while plenty of people who get influenza simply spend enough time in bed to rewatch the entire Game of Thrones series (speaking from experience here) and then move on with their lives, the virus can be much more than a wintertime nuisance.
In fact, the Centers for Disease Control and Prevention (CDC) estimates that the flu is responsible for up to 700,000 hospitalizations—and more than 50,000 deaths—in the US each year, due to a laundry list of complications it can cause. (And flu season isn’t limited to the big first wave of illnesses, which tends to take place annually around the December holidays—according to the most recent data about infection rates available from the CDC, we’re not quite out of the woods yet this year.) Catching this particular bug sometimes becomes much more serious than just having to take a few days off work, and that risk includes its potential consequences for your heart.
One small 2018 study reported that people are over six times more likely to have a heart attack in the week following a flu diagnosis. (More recently, preliminary research that replicated that study showed a slightly weaker, but still significant, association between the two.) And while flu-driven havoc on the heart is more common among older people and those with cardiovascular conditions, everyone should be mindful of it, Thomas Russo, MD, chief of the division of infectious disease at the University at Buffalo School of Medicine in New York, tells SELF—yep, even if you’re in your 20s or 30s and seemingly healthy.
Here’s what you should know about how the flu can affect your heart and how you can keep things ticking as usual, even if you do spend some time laid up sick in bed this season.
Yes, the flu is a respiratory virus, but that doesn’t mean it only spells trouble for your nose, throat, and lungs.
Though it’s less common for the flu to mess with your other organs, it can happen. “When we’re infected with influenza, our bodies react with inflammation to fight off the virus,” Estelle Darlyse Jean, MD, a board-certified non-invasive cardiologist with MedStar Heart & Vascular Institute in Maryland, tells SELF. It’s thought that “this process can rarely lead to cardiac complications, such as a heart attack, heart failure, inflammation of the heart muscle (myocarditis), and inflammation of the lining of the heart (pericarditis),” Dr. Jean says, because it increases stress on your heart and raises your blood pressure, which can, in turn, lead to clogs in your arteries that disrupt your blood flow. Some research performed on mice suggests that the flu virus can directly affect the heart’s cells, too, but more research is needed to determine whether this might affect humans in the same way.
Who’s at the greatest risk of heart problems caused by the flu?
Though anyone can be affected by flu-related heart issues, people with preexisting heart conditions like heart disease or hypertension (a.k.a. high blood pressure) are especially at risk, according to Dr. Jean. That’s a lot of people. An estimated 5.5% of American adults have heart disease, according to the CDC—and nearly half have high blood pressure. (These figures include more young folks than you might think: Research suggests that 27% of people in the US between the ages of 20 and 40 have hypertension, a well-established risk factor for various cardiovascular conditions.)
Dr. Russo notes that heart-related health issues like hypertension and atherosclerosis (thickening or hardening of the arteries) sometimes start quietly developing in your 20s. Because that can sometimes happen without your feeling or showing any obvious symptoms, plenty of people go about their day-to-day lives without even knowing something is off, Dr. Russo says. This suggests that the actual rates of heart health issues in younger folks are likely higher than the official stats and that more people ultimately face a higher risk of heart complications with the flu than they might even know.
As if that’s not troubling enough, having a heart issue (whether you’ve been diagnosed with one or not) can become life-threatening should the flu hit you hard. “When you have a heart that’s compromised to a degree or is only marginally supported, the stress and inflammation of an infection like the flu can basically push your heart over the edge, leading to a heart attack or an abnormal heart rhythm that could potentially be fatal,” Dr. Russo explains.
Other health conditions—such as diabetes, kidney disease, a history of stroke, or a compromised immune system—can increase your risk of heart complications related to the flu, adds Dr. Jean. Otherwise, lifestyle factors like smoking, a sedentary lifestyle, and what you eat can also up your chance of flu-related cardiac trouble, both experts say. Usually, if you’re under 65 and otherwise healthy, you should only experience a mild case and recover just fine.
Here’s when the flu poses the biggest risk to your heart—and the symptoms you should pay attention to.
The risk of developing heart complications related to the flu is highest if you have a serious case that requires hospitalization: A 2020 study found that about 12% of adults hospitalized for the flu develop a serious and sudden heart complication, such as acute heart failure (in which the heart’s blood-pumping ability is significantly weakened) and acute ischemic heart disease (which reduces blood flow to the heart because of narrowed arteries). In the study, those at particular risk included older individuals and those with underlying heart disease.
The risk of heart issues lingers even after you recover from your initial string of symptoms. “In the weeks following influenza infection, it’s still possible that you could have a cardiac complication, probably from ongoing inflammation that hasn’t completely resolved,” Dr. Russo explains.
If you’re sick with the flu right now or newly on the mend, the experts SELF spoke with recommend knowing what symptoms are commonly associated with cardiac emergencies, including heart failure, heart attack, and stroke, in case you need to seek immediate care.
“Chest discomfort, pain in the arms, back, neck, jaw, or stomach, shortness of breath, nausea, cold sweats, and lightheadedness can all indicate a heart attack” or other cardiac events, says Dr. Jean, and “drooping of the face, arm weakness, and speech difficulty can signal a stroke.”
Don’t just assume these symptoms will pass on their own or that they’re not serious, Dr. Russo urges. He always recommends getting checked out if you have persistent chest pain or pressure or difficulty breathing either when you’re sick or after the rest of your flu symptoms alleviate—either could signal trouble for your heart or another serious complication from the flu. In those cases, heading to the ER is your best move, Dr. Russo says.
How to protect your heart throughout flu season
Whether you’ve had a run-in with the flu or not this winter, checking all the usual boxes to protect your health, in general, will help keep your immune system strong and minimize your risk of potential heart complications should you get sick: Think things like eating well and getting enough sleep (eight hours a night is the goal), according to Dr. Russo. As ever, wash your hands thoroughly and do your best to stay away from others who are or might be sick.
The other no-brainer is to get your flu shot. Ideally, you should do this by the end of October, but the shot is available through late spring and offers protection after two weeks, so it’s not too late if you haven’t done it yet this year. Though the vaccine can’t guarantee you won’t catch the flu, “You’ll have a much milder illness and be less likely to land in the hospital and have bad consequences from an infection,” Dr. Russo says.
If heart disease or risk factors for heart disease run in your family, Dr. Jean also recommends checking in with a primary care provider or making an appointment with a cardiologist to get a clear, current picture of your heart health, talk about any symptoms you might be experiencing, and create a lifestyle game plan to support your well-being.
If you come down with the flu and are concerned about potential complications, see a doctor to talk through whether you should take prescription antiviral drugs, which can shorten the length of your illness, reduce or ease symptoms, and cut down on the chance of the flu contributing to a more serious health problem. If you do have preexisting heart issues, this is a generally good idea—if not, you can still take antiviral meds, but most people with mild flu symptoms don’t necessarily need to. Otherwise, rest up to help your immune system out as it fights off the virus—you’ll want to get as much sleep as you can to potentially feel better sooner.
These aren’t just solid methods for keeping you out of a bed surrounded by a million crumpled up tissues: Thinking about flu as a potentially long-term cardiac illness and arming yourself with information and precautions accordingly might do your heart a lot of good in the long run.
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