A major new study has found that adults with better cardiovascular health may be significantly less likely to experience severe COVID-19 outcomes, even if they have never been diagnosed with heart disease. The findings highlight the broader benefits of maintaining a healthy lifestyle and suggest that heart health could play an important role in protecting against serious infectious illnesses.
Researchers analyzed data from nearly 30,000 adults across the United States and discovered that individuals with the highest levels of cardiovascular health had substantially lower rates of COVID-19 hospitalization and death compared with those with poorer cardiovascular health.
The study was published in the Journal of the American Heart Association and examined the relationship between cardiovascular wellness and severe COVID-19 during the first three years of the pandemic.
The research focused on the American Heart Association's "Life's Essential 8" (LE8), a cardiovascular health measurement system designed to evaluate overall heart and brain health.
The eight components include:
Each category receives a score, and the combined score ranges from 0 to 100. Higher scores indicate better cardiovascular health.
Participants were categorized into three groups:
The investigation used data from the Collaborative Cohort of Cohorts for COVID-19 Research (C4R), a nationwide research consortium that combines information from multiple long-term health studies.
Researchers included 29,740 adults who did not have diagnosed cardiovascular disease before the COVID-19 pandemic began. The average participant age was approximately 66 years, and the study population represented diverse racial and ethnic backgrounds across the United States.
Between March 2020 and February 2023, researchers identified 4,500 COVID-19 infections among participants. Of those infections, 681 cases resulted in severe outcomes, defined as COVID-19-related hospitalization or death.
One of the most important findings was the strong association between cardiovascular health and severe COVID-19 outcomes.
Compared with individuals who had low cardiovascular health scores, participants with high cardiovascular health experienced a significantly lower risk of severe COVID-19.
Researchers reported that:
Interestingly, better cardiovascular health did not appear to reduce the likelihood of getting infected with COVID-19. Instead, it was associated with a reduced likelihood of developing serious complications after infection occurred.
This distinction suggests that cardiovascular health may influence how the body responds to illness rather than preventing viral exposure.
Among the eight Life's Essential 8 components, four factors demonstrated particularly strong associations with reduced severe COVID-19 risk.
Participants with higher physical activity levels experienced lower rates of severe COVID-19.
Regular exercise has long been linked to improved immune function, reduced inflammation, and better cardiovascular performance. These benefits may help the body respond more effectively during viral infections.
Body mass index emerged as one of the strongest predictors of severe COVID-19 outcomes.
Individuals with healthier BMI levels were less likely to experience hospitalization or death from COVID-19. Previous research has consistently shown that obesity increases the risk of respiratory complications and severe infections.
Optimal blood pressure was associated with a lower likelihood of severe COVID-19.
Researchers noted that healthier blood pressure levels may reflect lower levels of chronic inflammation and better overall cardiovascular function, both of which could contribute to improved outcomes during infection.
Sleep quality and duration also played a meaningful role.
Participants with healthier sleep patterns demonstrated lower risks of severe COVID-19. Sleep is essential for immune system regulation, recovery, and overall health, making this finding consistent with previous research on infectious disease susceptibility.
Although the study was observational and cannot prove cause and effect, researchers proposed several possible explanations.
COVID-19 can affect multiple organ systems, including the heart and blood vessels. Severe infections often trigger widespread inflammation, increase metabolic demands, and place additional stress on the cardiovascular system.
People with stronger cardiovascular health may have greater physiological resilience when faced with these challenges.
Researchers also noted that cardiovascular health has been linked to lower risks of numerous chronic conditions, including stroke, heart failure, kidney disease, and cognitive decline. The same protective mechanisms may help reduce vulnerability to severe infectious diseases.
The findings have important implications beyond COVID-19.
Researchers suggest that improving cardiovascular health could become an important strategy for reducing the burden of future respiratory infections and emerging viral threats.
Millions of adults have suboptimal cardiovascular health. Previous national estimates indicate that only a minority of Americans achieve high cardiovascular health scores, while many fall into moderate or low categories.
If cardiovascular health truly influences infectious disease outcomes, public health initiatives focused on exercise, weight management, blood pressure control, and healthy sleep habits could provide benefits that extend beyond traditional heart disease prevention.
The study also found that Life's Essential 8 modestly improved prediction of severe COVID-19 risk, particularly among adults younger than 65 years and among Hispanic participants.
While the results are encouraging, several limitations should be considered.
First, this was an observational study, meaning researchers identified associations rather than direct causation. It cannot definitively prove that improving cardiovascular health will reduce severe COVID-19 risk.
Second, cardiovascular health measurements were collected before the pandemic and were not continuously updated during follow-up. Participants' health behaviors may have changed over time.
Third, researchers could not account for every possible factor influencing COVID-19 outcomes, such as masking behavior, social distancing practices, or certain medical conditions.
Finally, the study population was based in the United States, so findings may not apply equally to populations in other countries.
This large national study provides compelling evidence that better cardiovascular health is associated with a lower risk of severe COVID-19 among adults without preexisting cardiovascular disease.
The strongest protective factors included regular physical activity, maintaining a healthy body weight, controlling blood pressure, and getting adequate sleep.
While more research is needed to determine whether actively improving cardiovascular health can directly reduce severe COVID-19 risk, the findings reinforce a broader message: healthy lifestyle habits benefit far more than just the heart. They may also improve resilience against serious infectious illnesses and future public health threats.
Plante TB, Sun Y, Balte PP, Lloyd-Jones D, Ning H, Allen N, Mongraw-Chaffin M, Oelsner EC, et al. Life's Essential 8 and Risk of Severe COVID-19 Among Adults Without Clinical Cardiovascular Disease: The C4R Study. Journal of the American Heart Association. Published online April 27, 2026.
This article is intended for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. The study discussed reports observational findings and does not prove that improving cardiovascular health directly prevents severe COVID-19. Individuals should consult qualified healthcare professionals regarding personal health concerns, prevention strategies, or treatment decisions.
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