[Comprehensive cardiovascular prevention: the role of vaccination in older adults with cardiovascular disease. Expert...

Respiratory and systemic infections can trigger cardiovascular events by increasing inflammation, atherosclerotic plaque instability, and a prothrombotic state. Given this situation, vaccination is a relevant preventive tool in patients with cardiovascular disease (CVD).

To review the available evidence on the impact of vaccination in patients with CVD and to propose recommendations to improve vaccination coverage in clinical practice.

This expert consensus, developed through a structured narrative review and panel discussion rounds, synthesizes the evidence on vaccination against influenza, pneumococcal disease, respiratory syncytial virus (RSV) infection, COVID-19, and herpes zoster in patients with CVD. The influenza vaccine presents the strongest evidence for reducing cardiovascular events, especially after acute episodes and in high-risk patients. For vaccination against pneumococcal disease, COVID-19, RSV infection, and herpes zoster, although direct cardiovascular evidence is more limited, the reduction in infections and hospitalizations supports its recommendation for a comprehensive preventive approach.

Vaccination is part of a comprehensive cardiovascular prevention approach. Improved coverage, supported by shared pathways between cardiology and primary care, along with public health services, can result in fewer infectious complications, fewer cardiovascular decompensations, and better clinical outcomes.