Better heart health before the pandemic was associated with a lower risk of severe COVID-19 events, according to research published today in the Journal of the American Heart Association. The study, which included nearly 30,000 adults without pre-existing cardiovascular disease, found that those with the highest scores on the American Heart Association's Life's Essential 8 metric had a 46% reduction in the risk of COVID-19 hospitalization or death compared to those with the lowest scores.
The Life's Essential 8 metric evaluates diet, physical activity, smoking, sleep, body mass index, blood pressure, cholesterol and blood sugar. Researchers used data from the Collaborative Cohort of Cohorts for COVID-19 Research (C4R), a collaboration of 14 U.S. studies that followed participants before and during the pandemic. The analysis focused on adults with an average age of 66, of whom 61% were women.
“Our findings suggest that the tremendous impact of COVID-19 on the U.S. could have been reduced if the general population had had better heart health prior to the onset of the pandemic,” said lead study author Tim Plante, M.D., M.H.S., an associate professor of medicine at the Larner College of Medicine at the University of Vermont.
For every 14-point increase in Life's Essential 8 score, the risk of severe COVID-19 fell by 20%. Higher scores for physical activity, healthy weight, blood pressure and sleep were individually associated with lower risk. The benefit was consistent across age, sex, race, ethnicity and vaccination status.
“In many ways, a viral infection is like a cardiac stress test, except it's not controlled,” said senior author Elizabeth C. Oelsner, M.D., Dr.P.H., associate professor of medicine at Columbia University Irving Medical Center. “Our results highlight that better heart health, which is something that individuals can work on, likely prepares you better for real-life stress tests such as infectious diseases like COVID-19.”
The study adds to growing evidence that heart health is important for protecting against infections. Sadiya S. Khan, M.D., M.Sc., FAHA, chair of the American Heart Association's Epidemiology Statistic Committee, who was not involved in the research, noted that “healthy lifestyle habits make a difference for preventing heart disease, which can sometimes feel like a vague and far-off goal for people, and also for more direct health benefits such as preventing adverse outcomes from respiratory infections.”
Khan emphasized the importance of vaccination, particularly in older adults and those with low heart health or a diagnosis of heart disease. The study's limitations include its observational nature, meaning cause and effect could not be established, and that heart health was only measured before or at the beginning of the pandemic. More research is needed to assess how changes in heart health during the pandemic may have affected COVID-19 outcomes.
The findings were published in the Journal of the American Heart Association, an open-access, peer-reviewed journal. The American Heart Association receives more than 85% of its revenue from non-corporate sources, and its financial information is available here. Additional resources, including the Life's Essential 8 My Life Check calculator, can be found on the American Heart Association website.
