Better heart health before the COVID-19 pandemic was associated with a substantially lower risk of severe COVID-19 outcomes, according to new research published in the Journal of the American Heart Association. The study found that adults with the highest heart health scores at the start of the pandemic were nearly half as likely to be hospitalized or die from COVID-19 compared with those who had the lowest scores. Researchers say the findings highlight the broader importance of cardiovascular health in helping the body respond to major infectious diseases.
People with cardiovascular disease have long been recognized as being at increased risk for severe COVID-19 infection. However, less was known about whether heart health influenced COVID-19 severity among adults without diagnosed cardiovascular disease. Lead study author Dr. Tim Plante, an associate professor of medicine at the University of Vermont, noted that understanding the relationship between heart health and COVID-19 outcomes is critical given the pandemic’s enormous impact. He suggested that better overall cardiovascular health in the population before the pandemic may have reduced the burden of severe illness and deaths in the United States.
Researchers evaluated the heart health of nearly 30,000 adults using the American Heart Association’s Life’s Essential 8 metric. This measure assesses diet, physical activity, smoking status, sleep, body mass index, blood pressure, cholesterol and blood sugar. Participants with high Life’s Essential 8 scores, ranging from 80 to 100, experienced a 46% lower risk of COVID-19 hospitalization or death compared with those who had low scores below 50. In addition, every 14-point increase in the heart health score was associated with a 20% reduction in the risk of severe COVID-19 outcomes.
The analysis also found that several individual components of cardiovascular health were especially important. Higher levels of physical activity, healthier body weight, optimal blood pressure and better sleep patterns were each linked to a lower risk of severe COVID-19 infection. Senior study author Dr. Elizabeth Oelsner of Columbia University Irving Medical Center explained that viral infections can place major stress on the body, similar to an uncontrolled cardiac stress test. According to Oelsner, people with stronger heart health may be better prepared to withstand the physiological stress caused by infectious diseases such as COVID-19.
The study drew data from the Collaborative Cohort of Cohorts for COVID-19 Research, or C4R, which combines information from 14 long-running U.S. health studies. The analysis included 29,740 adults without cardiovascular disease as of March 2020. Participants had an average age of 66 years, 61% were women, and the study population represented diverse racial and ethnic backgrounds. Between March 2020 and February 2023, researchers documented 681 severe COVID-19 cases. More than half of the participants had received a COVID-19 vaccine before becoming infected. Importantly, the protective relationship between heart health and severe COVID-19 outcomes remained consistent across age, sex, race, ethnicity and vaccination status.
Although the study was observational and could not establish direct cause and effect, experts say the findings add to growing evidence that cardiovascular health influences more than heart disease risk alone. Dr. Sadiya Khan of Northwestern University, who was not involved in the research, noted that healthy lifestyle habits may provide both long-term cardiovascular benefits and more immediate protection against severe respiratory infections. Researchers emphasized that maintaining good heart health through regular physical activity, healthy weight management, adequate sleep and blood pressure control may strengthen resilience against future infectious disease threats. At the same time, vaccination remains an important tool for preventing serious COVID-19 complications.
More information: Tim Plante et al, Life’s Essential 8 and Risk of Severe COVID‐19 Among Adults Without Clinical Cardiovascular Disease: The C4R Study, Journal of the American Heart Association. DOI: 10.1161/JAHA.125.048256
Journal information: Journal of the American Heart Association Provided by American Heart Association
