Adults with better heart health before the COVID-19 pandemic were nearly half as likely to be hospitalized or die from the infection, according to research published today in the Journal of the American Heart Association. The study, which analyzed nearly 30,000 adults without cardiovascular disease, used the American Heart Association’s Life’s Essential 8 metric to assess heart health.
Researchers found that participants with high Life’s Essential 8 scores (80 to 100) had a 46% reduction in risk of severe COVID-19 compared to those with low scores (less than 50). For every 14-point increase in the heart health score, the risk dropped by 20%. The components most strongly associated with lower risk were physical activity, body mass index, blood pressure, and sleep.
“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 author Tim Plante, M.D., M.H.S., associate professor at the Larner College of Medicine at the University of Vermont. The study, part of the Collaborative Cohort of Cohorts for COVID-19 Research (C4R), included participants from 14 U.S. studies with an average age of 66 years, 61% women, and diverse racial and ethnic backgrounds.
Senior author Elizabeth C. Oelsner, M.D., Dr.P.H., from Columbia University Irving Medical Center, noted, “In many ways, a viral infection is like a cardiac stress test, except it’s not controlled. 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 evidence that heart health is crucial not only for preventing cardiovascular disease but also for protecting against severe outcomes from 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, emphasized that “healthy lifestyle habits make a difference for preventing heart disease and for more direct health benefits such as preventing adverse outcomes from respiratory infections.” She also stressed the importance of vaccination, particularly for older adults and those with low heart health.
The analysis included 681 severe COVID-19 cases documented between March 1, 2020, and February 28, 2023. The heart health benefit was consistent across age, sex, race, ethnicity, and vaccination status, and persisted as the pandemic evolved. Study limitations include its observational nature and the fact that heart health was only measured before or at the beginning of the pandemic.
The findings underscore that maintaining good heart health is a modifiable factor that can reduce the risk of severe COVID-19. The American Heart Association’s Life’s Essential 8 metric provides a framework for individuals to assess and improve their cardiovascular health. For more information, visit the My Life Check calculator and the manuscript online.
