Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Intended for Healthcare Professionals
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
  • Subscribe BJGP on YouTube
Intended for Healthcare Professionals
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
Editorials

Beyond COVID-19: respiratory infection and cardiovascular events

Joseph J Lee, Constantinos Koshiaris, FD Richard Hobbs and James P Sheppard
British Journal of General Practice 2021; 71 (709): 342-343. DOI: https://doi.org/10.3399/bjgp21X716477
Joseph J Lee
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Roles: National Institute for Health Research Clinical Doctoral Fellow
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Constantinos Koshiaris
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Roles: Senior Medical Statistician
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
FD Richard Hobbs
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Roles: Nuffield Professor of Primary Care Health Sciences
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James P Sheppard
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Roles: University Research Lecturer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info
  • eLetters
  • PDF
Loading

INFECTIONS TRIGGER CARDIOVASCULAR DISEASE

When someone has an infection their risk of having a heart attack or stroke rises abruptly before returning to pre-infection levels over the next few weeks.1 The increase in risk is particularly high for respiratory infections like influenza and pneumonia. There are biologically plausible mechanisms by which infections could cause cardiovascular disease (CVD). Respiratory infections could trigger CVD by functional changes, like tachycardia, blood pressure instability, and hypercoagulable states. Increased cardiac demand can be enough to cause myocardial ischaemia downstream of stenosed vessels, even if the obstruction is stable.2 Infection might worsen or trigger existing CVD. Atheroma is thought to result from inappropriate inflammation. Infection could accelerate this inflammatory process, and destabilise plaques, much as chronic inflammatory conditions worsen coronary disease. Infections are also triggers for arrhythmias, which can in turn cause myocardial infarction and stroke. But even if the association between infections and CVD is only a marker of risk and not causative, it could still be useful clinically. There are precedents for short-term interventions: for example, temporary dual antiplatelet therapy after transient ischaemic attacks (TIAs). The benefit of prevention is proportional to the risk of CVD events, so treatments can be beneficial during periods of higher risk, when the balance of risks to benefits favours intervention.

A typical question GPs ask is: ‘Why has this person got this disease at this time?’ Often we focus on the diagnosis and cause but forget the temporal element, or at least don’t take it into account in our practice. At one time, even death was assumed to strike people at random. During the plague, London …

View Full Text

  RCGP login

Members, please Login at RCGP to access the journal online.

  Subscriber login

Enter your BJGP login information below.

Log in using your username and password

Enter your British Journal of General Practice username.
Enter the password that accompanies your username.
Forgot your user name or password?

Log in through your institution

You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$35.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

  Subscribe

Subscribe to the Journal - Subscribe to the print and/or online journal.

Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 71 (709)
British Journal of General Practice
Vol. 71, Issue 709
August 2021
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Beyond COVID-19: respiratory infection and cardiovascular events
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Beyond COVID-19: respiratory infection and cardiovascular events
Joseph J Lee, Constantinos Koshiaris, FD Richard Hobbs, James P Sheppard
British Journal of General Practice 2021; 71 (709): 342-343. DOI: 10.3399/bjgp21X716477

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Beyond COVID-19: respiratory infection and cardiovascular events
Joseph J Lee, Constantinos Koshiaris, FD Richard Hobbs, James P Sheppard
British Journal of General Practice 2021; 71 (709): 342-343. DOI: 10.3399/bjgp21X716477
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • INFECTIONS TRIGGER CARDIOVASCULAR DISEASE
    • CLINICAL PRACTICE
    • RISK PREDICTION AND INTERVENTIONS
    • Notes
    • REFERENCES
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • Continuity of GP care: using personal lists in general practice
  • Creating space for gut feelings in the diagnosis of cancer in primary care
  • GP workforce crisis: what can we do now?
Show more Editorials

Related Articles

Cited By...

Intended for Healthcare Professionals

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2022 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242