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You probably already know that high blood pressure and cholesterol can raise your risk of heart disease. But some other health issues, such as psoriasis, flu, and even sleep disorders, can also harm your heart.
“When you look at all these conditions, they all have one thing in common: inflammation,” says Donald M. Lloyd-Jones, M.D., chair of the department of preventive medicine at Northwestern University in Chicago and a spokesperson for the American Heart Association (AHA). Inflammation—when your immune system is in overdrive—can damage blood vessels, accelerating the progression of heart disease. Getting such conditions under control, however, can go a long way. Here’s what you need to know.
Flu and Pneumonia
Research suggests that flu and pneumonia may hike heart risks for some. For instance, a study published in 2018 in the New England Journal of Medicine found that people who had been previously hospitalized for heart attacks were about six times more likely to have a heart attack within a week of getting the flu, compared with the year before or the year after.
“The flu causes inflammation throughout your body, including your heart,” explains Lloyd-Jones.
What to do: Make sure you get an annual flu shot and if you’re in one of the recommended groups, that you’re up to date with the pneumonia vaccine (two shots are generally given a year apart).
If you get either illness and you already have heart disease, make sure you continue taking any prescribed heart medications.
And “if you feel exhausted, or start sweating or suddenly begin experiencing what feels like extreme indigestion, don’t just brush it off as feeling lousy from the flu,” says Lloyd-Jones. See your doctor right away or head to the emergency room.
Type 2 Diabetes
People with type 2 diabetes are two to four times more likely to die from heart disease than those who don’t have the condition, according to the AHA. And 68 percent of people over age 65 with type 2 diabetes die from some form of heart disease, while 16 percent die of stroke.
“Over time, high levels of blood glucose damage your blood vessels and the nerves that control them, making it more likely that you’ll develop heart disease,” explains Grenye O’Malley, M.D., a diabetes specialist at the Icahn School of Medicine at Mount Sinai.
What to do: Blood pressure should be checked at every doctor’s visit, and if it’s over 140/90, you’ll need to start medication. You’ll also need to get your cholesterol checked annually.
Getting tight control of your blood glucose levels is also key, but if you’re over age 70 and are already on multiple medications, pushing your levels too low “may actually be harmful,” says Adam Cifu, M.D., professor of medicine at the University of Chicago.
Though metformin is still the first line of treatment for people with type 2 diabetes, if this one drug isn’t enough, consider one of the glucagon-like peptide-1 receptor agonists (GLP-1), such as liraglutide (Victoza). Patients with type 2 diabetes at high risk of heart disease who took liraglutide had a reduced risk of having a heart attack or stroke, according to a study published last year.
Shingles
About 1 out of 3 people will get shingles, a condition in which the chickenpox virus—dormant in almost all adults who had chickenpox in childhood—reactivates in later life. It causes a blistering, painful rash that lasts a couple of weeks, and about 10 percent of people experience postherpetic neuralgia, or nerve pain that lingers for months or even years.
Shingles is also linked to a 41 percent rise in the risk of heart attack and stroke, according to a 2017 research letter. According to one theory, the virus that causes shingles may also create inflammation and damage in the arteries.
What to do: If you’re over age 50, get the shingles vaccine. A new version, Shingrix, became available in 2017, and it’s more than 90 percent effective at preventing shingles, according to the Centers for Disease Control and Prevention. (You get two doses, spaced two to six months apart.)
You should still get it even if you’ve already had shingles, and even if you have already received the older shingles vaccine, Zostavax.
Psoriasis and Rheumatoid Arthritis
These autoimmune disorders both come with persistent inflammation, which eventually reaches blood vessels and makes them more prone to clogging or rupture.
Research shows that people with rheumatoid arthritis have up to a 70 percent higher chance of developing heart disease than those without rheumatoid arthritis, and those with psoriatic arthritis (a form of psoriasis) have a 36 percent higher risk of heart attack. But many primary care physicians may not be aware of these risks.
What to do: Your first step is to make sure your condition is completely under control, says Iris Navarro-Millán, M.D., a rheumatologist at the Hospital for Special Surgery in New York.
For example, several studies have shown that patients with rheumatoid arthritis who are on a treatment like methotrexate have a 15 to 85 percent reduced risk of getting or dying from cardiovascular disease. And when you treat psoriasis with biologic drugs, it can reduce early plaque buildup that clogs up arteries, according to a study published this past March in the medical journal Cardiovascular Research. You also need to make sure that you’re getting the right heart-healthy preventive care.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA), a condition marked by pauses in breathing during sleep, leads to sudden drops in blood oxygen levels and awakenings that “increase blood pressure and cause your body to release stress hormones like adrenaline and epinephrine,” explains Beth Malow, M.D., director of the Sleep Disorders Division at Vanderbilt University Medical Center.
Yet survey results published in the Journal of the American Geriatrics Society found that while 56 percent of people over age 65 were at high risk for OSA, only 8 percent had actually been tested.
What to do: If you snore regularly, have long breathing pauses followed by choking or gasping, or consistently don’t feel well-rested when you wake up, make an appointment with a sleep specialist, Malow says. If you do have apnea, the gold standard of treatment is continuous positive airway pressure (CPAP), where a mask connected to a pump gently blows air into your throat to keep the airway open.
In one study, people who used CPAP for just three months experienced a significant reduction in blood pressure.
The Heart-Mind Connection
Though being diagnosed with heart disease or having a heart attack is known for raising the risk of depression, the reverse may also be true.
“People with depression are more likely to have poor eating and exercise habits, as well as to drink or smoke,” says Lloyd-Jones. “But it does seem to go deeper than that.”
A study published earlier this year suggests that a missing link may be inflammation, which is a key risk factor for both conditions.
If you have symptoms of depression—especially if you are already at risk for heart disease—talk to your primary care provider about a treatment plan.
There’s also a condition called takotsubo cardiomyopathy (TC), or broken heart syndrome, that can mimic signs of a heart attack. In one study, about 1 to 2 percent of people with a suspected heart attack in the hospital actually had TC instead.
This temporary disruption of your heart’s pumping function is brought on by a stressful situation, such as a death. “The outpouring of stress hormones actively shocks the heart,” Lloyd-Jones says.
Treatment is usually hospitalization, along with medications to help your heart bounce back. Most people make a full recovery after a couple of weeks.
Editor’s Note: This article also appeared in the July 2019 issue of Consumer Reports On Health.
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