Better Heart Health Before Pandemic Linked to Lower Risk of Severe COVID-19
Adults with higher heart health scores before the pandemic were nearly half as likely to be hospitalized or die from COVID-19, according to new research in the Journal of the American Heart Association.
Better heart health before the pandemic was associated with a lower risk of severe COVID-19, according to a study published today in the Journal of the American Heart Association. The research found that adults with the highest heart health scores, as measured by the American Heart Association’s Life’s Essential 8 metric, were 46% less likely to be hospitalized or die from COVID-19 compared to those with the lowest scores.
The study, which analyzed data from nearly 30,000 adults without cardiovascular disease, highlights that even among those without known heart conditions, heart health plays a critical role in resilience against severe infection. “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 author Tim Plante, M.D., M.H.S., an associate professor at the Larner College of Medicine at the University of Vermont.
Using Life’s Essential 8—which evaluates diet, physical activity, smoking, sleep, body mass index, blood pressure, cholesterol, and blood sugar—researchers found that for every 14-point increase in heart health score, the risk of severe COVID-19 dropped by 20%. Specifically, higher scores for physical activity, healthy weight, optimal blood pressure, and better sleep were individually linked to lower risk.
The findings underscore the importance of heart health as a preventive measure against infectious diseases. “In many ways, a viral infection is like a cardiac stress test, except it’s not controlled,” said senior author Elizabeth C. Oelsner, M.D., Dr.P.H., associate professor at 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 like COVID-19.”
The study, part of the Collaborative Cohort of Cohorts for COVID-19 Research (C4R), included 29,740 adults with an average age of 66, 61% of whom were women. Participants were followed from March 2020 to February 2023, during which 681 severe COVID-19 cases were documented. The heart health benefit was consistent across age, sex, race, ethnicity, and vaccination status.
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, noted that healthy lifestyle habits make a difference for preventing heart disease and also for 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.
While the study was observational and cannot establish cause and effect, it adds to growing evidence that better heart health is crucial for overall health and resilience against infections. The American Heart Association’s My Life Check calculator can help individuals assess their cardiovascular health.