Heart attacks may not just be caused by high cholesterol, poor diet and stress—they could be triggered by common viral infections, groundbreaking research has suggested.
A heart attack—medically known as myocardial infarction—is a serious medical emergency in which the supply of blood to the heart is suddenly restricted, usually by a clot.
Cardiovascular disease is the leading cause of death globally, claiming an estimated 17.9million lives each year. It has long been thought that coronary heart disease as well as a number of modifiable lifestyle factors such as smoking increases the risk of heart attack.
But now researchers say that the event could be triggered by a viral infection—as common as the flu or urinary tract infections (UTI).
Up to 1.7 million people in the UK, the majority of whom are women, suffer from recurrent UTIs. Symptoms include a burning sensation when going to the toilet, going more often than usual and feeling as if you still need to go when the bladder is empty.
It is thought to be the most common form of outpatient infection, resulting in a total of 1.2million NHS bed days last year.
In the study, scientists found that in coronary heart disease—caused by a buildup of fatty substances in the arteries blocking blood supply to the heart—cholesterol may harbour and protect bacteria that can lie dormant in the body for years.
According to the researchers, from Finland and the University of Oxford, the bacteria forms a protective biofilm to protect itself from a patient’s immune system and antibiotics.
Researchers now say that heart attacks could actually be infectious, with common viral infections like UTIS increasing the risk of the fatal event
But when a patient becomes ill, having caught a viral infection—such as a UTI—the virus can activate the biofilm, proliferating the bacteria and an inflammatory response.
High levels of inflammation can cause plaques in the heart to rupture, resulting in a potentially fatal blood clot and eventually a heart attack.
This inflammatory response, which triggers white blood cell production to help ward off infection, also increases the stickiness of cells in the blood called platelets, encouraging the formation of blood clots.
Professor Pekka Karhunen, an expert in biological sciences at Tampere University, Finland, and study lead, said: ‘Bacterial involvement in coronary artery disease has long been suspected, but direct and convincing evidence has been lacking.
‘Our study demonstrated the presence of genetic material—DNA—from several oral bacteria inside athersclerotic plaques.’
The research team also developed an antibody to detect biofilm structures in arterial tissue by looking at patients who had died from sudden cardiac death, as well as patients undergoing treatment to clear plaque build-up.
The researchers said whilst this does not mean that proven risk factors should be pushed aside, it may help may help pave the way for the development of new diagnostic strategies.
They added that their findings could advance the possibility of preventing coronary heart disease and even heart attack by vaccinating against common viral infections.
NHS data shows a rise in the number of younger adults suffering from heart attacks over the past decade. The biggest increase (95 per cent) was recorded in the 25-29 year-old demographic, though as numbers of patients are low even small spikes can look dramatic
In a 2018 study, published in the Journal of the American Heart Association, researchers found a strong connection between viral infections like pneumonia and UTIs and heart disease.
Researchers followed over 1,300 patients who had suffered a heart attack or other type of coronary event and found that around 37 per cent of heart disease patients had some type of infection with the previous three months.
UTIs were the most common type of infection reported in the study.
Dr Kamakshi Lakshminarayan, a neurologist and study lead author, said: ‘The infection appears to be the trigger for changing the finely tuned balance in the blood and making us more prone to blood clot formation.
‘It’s a trigger for the blood vessels to get blocked up and puts us at higher risk of serious events like heart attack and stroke.’
It comes as alarming data last year also revealed that premature deaths from cardiovascular problems had hit their highest level in more than a decade.
At the same time, there is growing concern that antibiotics used to treat viral infections like UTIs are becoming less effective, as bacteria becomes more resistant to treatment.
The Daily Mail has previously highlighted how the number of young people under 40 in England being treated for heart attacks by the NHS is on the rise.
Cases of heart attacks, heart failure and strokes among the under-75s had tumbled since the 1960s thanks to plummeting smoking rates, advanced surgical techniques and breakthroughs such as stents and statins.
But now, other factors such as slow ambulance response times for category 2 calls in England — which includes suspected heart attacks and strokes — as well as long waits for tests and treatment have also been blamed for the worrying reversal in progress.
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