DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS Viral infections, including influenza, SARS-CoV-2, HIV, hepatitis C, and herpes zoster, significantly elevate cardiovascular risk through shared inflammatory pathways. A systematic review and meta-analysis in the Journal of the American Heart Association analyzed 155 studies and found acute infections can quadruple MI risk within the first month, while chronic infections sustain elevated CHD and stroke risk for years.
Clinical Considerations
- Influenza triggers a 4x spike in acute MI risk and 5x stroke risk in the first month after confirmed infection.
- SARS-CoV-2 raises CHD risk by 74% and stroke risk by 69%, persisting beyond acute illness.
- HIV and hepatitis C sustain 27-60% elevated CHD risk, requiring long-term cardiovascular vigilance.
- Herpes zoster raises CHD risk 12% and stroke risk 18%, often overlooked in CV risk stratification.
Practice Applications
- Treat acute viral illness as a transient high-risk window; intensify secondary prevention during recovery.
- Incorporate influenza, COVID-19, zoster, and hepatitis A/B vaccination into CV risk reduction plans.
- Lower the threshold for CVD evaluation in patients with HIV, hepatitis C, or recent herpes zoster.
- Document viral infection history as a modifiable cardiovascular risk factor in patient records.
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