Influenza Vaccination and Cardiovascular Protection: Current and Emerging Evidence in Primary and Secondary Prevention

Influenza infection is increasingly recognized as an important cardiovascular risk factor beyond its traditional role as a respiratory illness. Influenza infection may precipitate myocardial infarction, stroke, heart failure exacerbation, and arrhythmias through systemic inflammation, endothelial dysfunction, thrombosis, and plaque destabilization. Growing evidence suggests that influenza vaccination may reduce cardiovascular events and hospitalization in both primary and secondary prevention settings, particularly among older adults and high-risk cardiovascular populations. Contemporary American and European guidelines increasingly recognize influenza vaccination as part of preventive cardiology and secondary cardiovascular prevention. This narrative review summarizes current evidence regarding influenza vaccination in primary and secondary cardiovascular prevention, with emphasis on mechanistic pathways, clinical outcomes, and future preventive strategies.