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Pneumonia or sepsis admission linked to higher risk of cardiovascular disease

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Pneumonia or sepsis in adults that results in hospital admission is associated with a six-fold increased risk of cardiovascular disease in the first year, according to Swedish researchers.

They found cardiovascular risk was more than doubled during the second and third year following the infection and persisted for at least five years.

“The risk remained notably raised for three years after infection”

Cecilia Bergh

Most patients with sepsis or pneumonia recover but the researchers noted that many still have high circulating inflammatory markers after the acute phase of the infection.

Their study examined if admission for sepsis or pneumonia was linked to an increased risk of cardiovascular disease in the years afterwards, and whether there was a particularly risky period.

It included 236,739 men born from 1952-56, who underwent extensive physical and psychological examinations at around the age of 18 as part of military conscription.

Using a national register of infection and cardiovascular disease diagnoses, the men were followed from late adolescence into middle age.

The researchers analysed the associations between a first infection that resulted in admission with subsequent cardiovascular disease risk at pre-specified time intervals after discharge.

In the period following army conscription, 46,754 of the men had a first diagnosis of cardiovascular disease. A total of 9,987 admissions for pneumonia or sepsis were identified among 8,534 men.

“Preventative therapies such as statins could be investigated”

Scott Montgomery

The researchers found that infection was associated with a 6.33-fold raised risk of cardiovascular disease during the first year after the infection.

In the second and third years following an infection, cardiovascular disease risk remained raised by 2.47 and 2.12 times.

The risk decreased with time, but was still raised for at least five years after the infection by nearly two-fold, said the study authors in the European Journal of Preventive Cardiology.

Similar findings were observed for coronary heart disease, stroke and fatal cardiovascular disease, they said, adding that the persistently raised risk could not be explained by subsequent severe infections.

They highlighted that the findings pointed to a causal relationship, since cardiovascular disease risk was very high immediately after infection and reduces with time.

“Our results indicate that the risk of cardiovascular disease, including coronary heart disease and stroke, was increased after hospital admission for sepsis or pneumonia,” said lead author Dr Cecilia Bergh from Örebro University.

Örebro University

Pneumonia or sepsis ‘increases risk of cardiovascular disease’

Cecilia Bergh

“The risk remained notably raised for three years after infection and was still nearly two-fold after five years,” she said.

When the researchers examined the relationship between other risk factors, such as hypertension, obesity and poor physical fitness, they found infection was associated with the highest magnitude of cardiovascular disease risk in the first three years after infection.

Senior study author Professor Scott Montgomery said: “Severe infections in adulthood are associated with a contemporaneously raised risk of cardiovascular disease. Whether this raised risk persists for several years after infection is less well established.

“Our findings provide another reason to protect against infection and suggest that there is a post-infection window of increased cardiovascular disease risk,” he said.

“We did not study any interventions that could be initiated during this period, but preventative therapies such as statins could be investigated,” he added.

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  • More awareness of sepsis needed.

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