DALLAS – A new study published today in the Journal of the American Heart Association has found that better heart health before the COVID-19 pandemic was associated with a significantly lower risk of severe outcomes, including hospitalization and death. The research, which analyzed data from nearly 30,000 adults without pre-existing cardiovascular disease, suggests that maintaining optimal heart health may help the body withstand the stress of viral infections.
The study used the American Heart Association’s Life’s Essential 8 metric, which evaluates diet, physical activity, smoking, sleep, body mass index, blood pressure, cholesterol, and blood sugar. Adults with high heart health scores (80 to 100) had a 46% reduction in risk of COVID-19 hospitalization or death compared to those with low scores (less than 50). Additionally, for every 14-point increase in the Life’s Essential 8 score, the risk of severe COVID-19 dropped by 20%.
“COVID-19 caused 1.22 million deaths in the U.S. between March 2020 and March 2025, so it’s essential that we understand how important health components, such as heart health, relate to severity of COVID-19 infections,” said lead study author Tim Plante, M.D., M.H.S., an associate professor of medicine at the Larner College of Medicine at the University of Vermont. “Our findings suggest that the tremendous impact of COVID-19 on the U.S. could have been reduced if the general population had had better heart health prior to the onset of the pandemic.”
The analysis, part of the Collaborative Cohort of Cohorts for COVID-19 Research (C4R), included 29,740 adults with an average age of 66 years, of whom 61% were women. About 18% had high heart health, 70% moderate, and 12% low. Among participants, 681 severe COVID-19 cases were documented between March 1, 2020, and February 28, 2023. The benefits of better heart health were consistent across age, sex, race, ethnicity, and vaccination status, and persisted throughout the pandemic.
“The findings suggest that having a healthy heart helps the body deal with the stress of a viral infection like COVID-19,” said senior study author Elizabeth C. Oelsner, M.D., Dr.P.H., of Columbia University Irving Medical Center. “In many ways, a viral infection is like a cardiac stress test, except it’s not controlled.” The study highlights that individual components of Life’s Essential 8, such as physical activity, body mass index, blood pressure, and sleep, were individually associated with lower risk.
Sadiya S. Khan, M.D., M.Sc., FAHA, chair of the American Heart Association’s Epidemiology Statistic Committee, noted that “healthy lifestyle habits make a difference for preventing heart disease, which can sometimes feel like a vague and far-off goal for people, and also for more direct health benefits such as preventing adverse outcomes from respiratory infections.” She emphasized the importance of vaccination, especially for older adults and those with low heart health or heart disease.
The study was published in the Journal of the American Heart Association, an open-access, peer-reviewed journal. Researchers used the American Heart Association’s Life’s Essential 8 metric to assess heart health. While the study was observational and cannot establish cause and effect, it adds to growing evidence that cardiovascular health is crucial for overall resilience against infections.
The findings underscore the potential public health impact of improving heart health at a population level. As the world faces ongoing and future infectious disease threats, these results may inform strategies to reduce severe outcomes through preventive health measures.
