Better heart health before the pandemic was associated with a lower risk of severe COVID-19 events, according to research published today in the Journal of the American Heart Association. The study, which analyzed nearly 30,000 adults without pre-existing cardiovascular disease, found that those with the highest heart health scores were nearly half as likely to be hospitalized or die from COVID-19 compared to those with the lowest scores.
Using the American Heart Association's Life's Essential 8 metric, which assesses diet, physical activity, smoking, sleep, body mass index, blood pressure, cholesterol, and blood sugar, researchers examined the relationship between heart health and severe COVID-19. The findings, published in the Journal of the American Heart Association, showed that adults with high Life's Essential 8 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). For every 14-point increase in the score, the risk decreased 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."
Higher scores for physical activity, weight management, blood pressure control, and sleep patterns were individually associated with lower risk. "The findings suggest that having a healthy heart helps the body deal with the stress of a viral infection like COVID-19," said senior author Elizabeth C. Oelsner, M.D., Dr.P.H., of Columbia University Irving Medical Center. "Our results highlight that better heart health, which is something that individuals can work on, likely prepares you better for real-life stress tests such as infectious diseases."
The analysis included 29,740 adults without clinical cardiovascular disease, with an average age of 66, and 61% women. Participants were from 14 U.S. studies, with extensive pre-pandemic health data. Between March 2020 and February 2023, 681 severe COVID-19 cases were documented. The heart health benefit was consistent across age, sex, race, ethnicity, and vaccination status.
"Healthy lifestyle habits make a difference for preventing heart disease and for more direct health benefits such as preventing adverse outcomes from respiratory infections," said Sadiya S. Khan, M.D., M.Sc., FAHA, chair of the American Heart Association's Epidemiology Statistic Committee, who was not involved in the research. The study emphasizes the importance of vaccination, particularly for older adults or those with low heart health.
While more research is needed, the findings add to evidence that heart health is crucial for overall resilience. The study was observational and could not establish cause and effect. However, it underscores that maintaining good heart health may protect against severe outcomes from infections like COVID-19.
