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What causes heart attacks? For decades, cardiologists have blamed high cholesterol. That's why about 50 million Americans are taking statin-type medications to lower their cholesterol.
Even though such drugs have been widely used for nearly 40 years, heart disease is still our No. 1 killer. Perhaps other factors are at play.
There is growing evidence that infections contribute to cardiovascular complications. A systematic review found evidence that influenza can lead to heart attacks and strokes. SARS-CoV-2 (the virus that causes COVID-19), respiratory syncytial virus (RSV) and Coxsackie B virus may all trigger heart attacks (Cardiovascular Research, June 17, 2025).
In a separate study, scientists analyzed medical records in Wales (BMJ Open, June 30, 2025). They discovered that 4.5% to 5% of patients admitted with a heart attack or stroke between 2010 and 2020 had a confirmed urinary tract infection. The investigators suggest that perhaps the inflammatory response to an acute infection sparks cardiovascular consequences. This idea was bolstered by a clear link between bloodstream infections and cardiovascular events (Open Heart, March 25, 2025).
Most people think of a respiratory infection as a brief interlude of ill health. Once it passes, you can go on about your business without worry.
Scientists have found evidence to the contrary, however. People who caught chicken pox as children harbor the varicella-zoster virus in the spinal column and brain for decades.
It can reemerge as shingles later in life. Research has found a link between shingles and heart attacks, TIAs (transient ischemic attacks) and strokes (Neurology, Jan. 21, 2014).
Another link between infection and cardiovascular disease is gum disease. Periodontitis is chronic inflammation of the gums around the teeth. Bacteria build up in dental plaque, release toxins and provoke an immune response.
Researchers have known for decades that people with periodontal disease are more prone to cardiovascular disease (Periodontology 2000, Nov. 23, 2023). Scientists are still figuring out how pathogens in the gums affect blood vessels in the heart and brain (Cellular Signaling, August 2025).
Microorganisms that start in the mouth may travel to blood vessels and trigger inflammation that damages the lining of those tissues. The authors point out that improved oral health care could represent a new way to prevent and treat heart disease.
Another approach that could reduce the burden of heart disease and stroke is vaccination. Immunizing people against influenza, RSV and shingles can help protect them from the chance of cardiovascular catastrophe as well as infection (Atherosclerosis, June 13, 2025; International Journal of Infectious Diseases, July 31, 2025; Clinical Infectious Diseases, Aug. 9, 2025).
Several studies have shown that people vaccinated against shingles are also at lower risk for developing dementia (Nature, April 2, 2025; JAMA, April 23, 2025). Such research is challenging neuroscientists who have not been considering infection as a contributing factor to Alzheimer's disease. It may be time for cardiologists and neurologists to start collaborating with infectious disease experts to address heart disease, stroke and dementia.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th St., 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is "Top Screwups Doctors Make and How to Avoid Them."