text: Importance Among nontraditional cardiovascular risk factors, recent influenzalike infection is associated with fatal and nonfatal atherothrombotic events. 
   
   Objectives To determine if influenza vaccination is associated with prevention of cardiovascular events. 
   
   Data Sources and Study Selection A systematic review and meta-analysis of MEDLINE (1946-August 2013), EMBASE (1947-August 2013), and the Cochrane Library Central Register of Controlled Trials (inception-August 2013) for randomized clinical trials (RCTs) comparing influenza vaccine vs placebo or control in patients at high risk of cardiovascular disease, reporting cardiovascular outcomes either as efficacy or safety events. 
   
   Data Extraction and Synthesis Two investigators extracted data independently on trial design, baseline characteristics, outcomes, and safety events from published manuscripts and unpublished supplemental data. High-quality studies were considered those that described an appropriate method of randomization, allocation concealment, blinding, and completeness of follow-up. 
   
   Main Outcomes and Measures Random-effects Mantel-Haenszel risk ratios (RRs) and 95% CIs were derived for composite cardiovascular events, cardiovascular mortality, all-cause mortality, and individual cardiovascular events. Analyses were stratified by subgroups of patients with and without a history of acute coronary syndrome (ACS) within 1 year of randomization. 
   
   Results Five published and 1 unpublished randomized clinical trials of 6735 patients (mean age, 67 years; 51.3% women; 36.2% with a cardiac history; mean follow-up time, 7.9 months) were included. Influenza vaccine was associated with a lower risk of composite cardiovascular events (2.9% vs 4.7%; RR, 0.64 [95% CI, 0.48-0.86], P = .003) in published trials. A treatment interaction was detected between patients with (RR, 0.45 [95% CI, 0.32-0.63]) and without (RR, 0.94 [95% CI, 0.55-1.61]) recent ACS (P for interaction = .02). Results were similar with the addition of unpublished data. 
   
   Conclusions and Relevance In a meta-analysis of RCTs, the use of influenza vaccine was associated with a lower risk of major adverse cardiovascular events. The greatest treatment effect was seen among the highest-risk patients with more active coronary disease. A large, adequately powered, multicenter trial is warranted to address these findings and assess individual cardiovascular end points. ||||| Get a flu shot to ward off a case of influenza, and as an added bonus you’ll reduce your risk of a heart attack, stroke or other type of unpleasant “cardiovascular event,” a new study finds. 
   
   For some time, researchers have suspected that flu shots can protect heart health as well as respiratory health. They have tested this theory in a handful of clinical trials, and the results have been mixed. 
   
   Now an international group of researchers has compiled data from a dozen randomized clinical trials to see if they could get a clearer answer to the question. What they found was “a consistent association between influenza vaccination and a lower risk of cardiovascular events,” according to their report in Wednesday’s edition of the Journal of the American Medical Assn. 
   
   Five of the trials the team examined were published in peer-reviewed journals and compared a flu vaccine to a placebo vaccine or other type of control. In those trials, 3,238 patients got a real vaccine and 95 of them – 2.9% – went on to experience “a major adverse cardiovascular event,” the JAMA report said. For the sake of comparison, 3,231 patients in those trials got a placebo or control and 151 of them – or 4.7% – later had a cardiovascular event, according to the study. 
   
   That translates into a 36% reduced risk of a serious heart problem simply by getting a flu shot – something everyone over the age of 6 months should be doing anyway. Based on these figures, the researchers calculated that one death or serious illness due to heart trouble could be prevented by vaccinating 58 additional people. 
   
   Three of the trials the researchers examined focused on patients with coronary artery disease. Some of those patients had recently experienced acute coronary syndrome, and they benefited the most by getting a flu shot. Patients who got the vaccine were 55% less likely to have a serious heart problem than patients in the control groups, the researchers found. The team calculated that for these patients, only eight additional people would need to get a flu shot in order to prevent one case of death or serious illness. 
   
   When the researchers considered cardiovascular deaths on their own, they found no statistically significant difference between the 1.3% of people who died after getting a flu shot and the 1.7% who died after being assigned to a placebo or control group. 
   
   Experts aren’t sure why the flu increases the risk of serious heart problems, but they have their theories. It may cause a plaque that has built up inside the arteries to rupture, or it may cause the heart muscle to become inflamed, among other possibilities. Knowing what’s going on inside the body would help figure out who would get an extra boost from a flu shot, and why. 
   
   Even with those uncertainties, the conclusion that a flu shot can protect patients with heart disease is convincing, according to an editorial that accompanies the study in JAMA. 
   
   “The estimate of 1.7 major cardiovascular events prevented for every 100 persons with cardiovascular disease vaccinated is plausible and would represent a significant public health benefit,” wrote Dr. Kathleen Neuzil, a vaccine expert at PATH, a Seattle-based nonprofit that focuses on global health. 
   
   If you're interested in news that helps you stay healthy, you like the things I write about. Follow me on Twitter and "like" Los Angeles Times Science & Health on Facebook. 
   
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   45% of Americans got a flu shot last year; CDC says we can do better ||||| NEW YORK (Reuters Health) - Getting a seasonal flu shot may do more than just prevent influenza. It may also lower a person's risk of heart problems, suggests a new study. 
   
   Researchers who took a fresh look at previously collected data found people who got flu shots were less likely to have heart problems during the next year than those who were given a fake shot, or placebo. That was especially true for people with recent heart troubles. 
   
   "If there are those out there who for whatever reason don't get the flu shot or don't feel that they need it … this is one more reason why they might help," Dr. Jacob Udell said. 
   
   Udell is the study's lead author from the University of Toronto's Women's College Hospital and Peter Munk Cardiac Center at Toronto General Hospital. 
   
   Previous reports have shown people who come down with the flu have an increased risk over the near term of having a stroke, heart failure and heart disease, he told Reuters Health. 
   
   It's thought the infection triggers inflammation throughout the body and can aggravate existing heart problems. 
   
   For the new study, the researchers searched several databases for trials that compared people who received the flu shot to others who did not. 
   
   They found five published studies and one unpublished study that included 6,735 participants. Participants were in their late 60s, on average. A little more than a third had a history of heart problems. 
   
   Overall, 3 percent of those who received a flu shot went on to have a heart problem including a heart attack or stroke within a year. That compared to about 5 percent of those in the placebo groups. 
   
   Among those with recent heart disease, the difference was more dramatic. 
   
   The researchers found about 10 percent of participants with a recent heart problem went on to have another after they received the flu shot. That compared to about 23 percent in the placebo groups. 
   
   "Clearly if you had a recent heart attack our research is showing … they're going to derive the most protection," Udell said. 
   
   "I think it adds a stronger bit of evidence to the recommendations that are currently being made," Dr. David Frid said. 
   
   Frid, a preventative cardiologist at the Cleveland Clinic in Ohio, was not involved with the new study. 
   
   "From the clinical perspective, it gives us more supporting data to say to our patients, ‘Here's a recent study confirming what we've been telling you that if you have heart disease you should be getting the flu vaccine,'" he told Reuters Health. 
   
   Dr. Kathleen Neuzil from the global health nonprofit organization PATH in Seattle wrote an editorial accompanying the new study in The Journal of the American Medical Association. 
   
   She cautions that the findings can't say the flu shot prevents heart problems. However, Neuzil writes that the known complications of flu among older people warrant the vaccine's use. 
   
   SOURCE: bit.ly/JOTmp1 The Journal of the American Medical Association, online October 22, 2013. ||||| Font Size A A A 
   
   Your Flu Shot May Also Help Your Heart 
   
   Study found one-third lower risk of problems including heart attacks in vaccinated people 
   
   
   
   WebMD News from HealthDay 
   
   By Serena Gordon 
   
   HealthDay Reporter 
   
   TUESDAY, Oct. 22 (HealthDay News) -- If avoiding an achy, feverish week or so laid up with the flu doesn't motivate you to get a flu shot, a new study linking flu shots to a lower incidence of heart disease might persuade you to roll up your sleeve. 
   
   People in the study who got flu shots were one-third less likely to have heart issues, such as heart failure or a heart attack, compared to those who opted against vaccination. The flu shot was associated with an even greater reduction of heart problems if someone had heart disease to start with, according to the study. 
   
   "This is one further piece of evidence to convince patients to go out and get their flu shot," said the study's lead author, Dr. Jacob Udell, a cardiology and clinician scientist, at Women's College Hospital at the University of Toronto. 
   
   Results of the study are published in the Oct. 23/30 issue of the Journal of the American Medical Association. 
   
   Past research has suggested a link between the influenza virus -- the virus that causes the flu -- and an increased risk of heart events. And, conversely, previous research done on the influenza vaccine has suggested an association between the vaccine and a reduced risk of heart issues. But, most of these studies were small and none looked specifically for a heart-protective effect from the influenza vaccine. 
   
   The flu vaccine is currently recommended for everyone over 6 months of age in the United States, according to the U.S. Centers for Disease Control and Prevention. The vaccine is highly recommended for certain groups, including people with heart disease. 
   
   To get an idea of how well the vaccine might protect against heart events, the researchers reviewed all of the clinical trials done on the influenza vaccine from 1947 through mid-2013. 
   
   The investigators included six randomized clinical trials comprising nearly 7,000 people in their analysis. The average age of the study participants was 67, and about half were women. Just over 36 percent had a history of cardiac disease. 
   
   The researchers found that those who received an influenza vaccine were 36 percent less likely to have a heart event than those who hadn't had a vaccine. 
   
   When the researchers looked at just the three trials that included people with recent heart disease, they found an even greater potential protective effect. People with recent heart problems who got the flu vaccine were 55 percent less likely to have another event compared to those who didn't get the vaccine. 
   
   The risk of dying from cardiovascular disease was nearly 20 percent lower for those who received the flu vaccine versus those who hadn't, according to the study. 
   
   Udell said this study wasn't designed to prove that influenza vaccine can lower heart disease risk, but he said that the researchers believe they've come close to proving cause and effect without conducting a clinical trial specifically designed to look for a protective effect from the flu vaccine.
target: – This year's public service announcements urging people to get a flu shot might have just gotten some extra ammo: New research suggests the shots not only help ward off the flu but protect the heart as well, reports the LA Times. An analysis of previous studies found that 3% of people who got the flu vaccine went on to have some kind of "cardiovascular event," as opposed to 5% who got a placebo, according to the study published in the Journal of the American Medical Association. That is, those who got flu shots reduced their risk by about a third of having a heart attack. "If there are those out there who for whatever reason don't get the flu shot or don't feel that they need it … this is one more reason why they might help," the lead researcher tells Reuters. So what's going on? WebMD explains a leading theory: The flu triggers an inflammatory immune response in the body, and that inflammation could spell trouble for arteries, especially ones already compromised. If the shot keeps the flu away, all that is avoided. The researchers say those who already have heart disease should be especially vigilant about getting the yearly flu vaccine.