Why RSV Protection Should Be a Priority in Malaysia’s Heart Disease Prevention Strategy

1 October 2025

KUALA LUMPUR: Every World Heart Day reminds us that prevention goes beyond medications and procedures. It involves addressing hidden triggers that can push vulnerable hearts into crisis. Respiratory syncytial virus, or RSV, is one such overlooked culprit. In older adults, RSV may seem mild initially but can inflame the body, strain the lungs, and trigger cardiac events in those with pre-existing heart conditions. A meta-analysis found that up to 20% of adult RSV cases experience cardiovascular complications such as heart failure, arrhythmias, myocardial infarction, or stroke.

“As cardiologists, we often see patients only after a crisis,” says Dato’ Sri Dr Azmee Mohd Ghazi, Head of Cardiology at Institut Jantung Negara. “RSV teaches us that preventing the infection can also prevent the cascade of cardiac problems that follow.”

This clinical insight is now reflected in recent guidelines. The European Society of Cardiology’s 2025 Consensus Statement highlights vaccination as a new form of cardiovascular prevention, especially for older adults and those with heart disease.

In Malaysia, cardiovascular disease remains a leading cause of death, with ischaemic heart disease accounting for around 15–18% of fatalities annually. Risk factors are widespread, with hypertension affecting about 30% of adults, hypercholesterolaemia prevalent at around 38%, and over half of the population overweight or obese, factors that heighten cardiometabolic risks. When a severe respiratory infection like RSV strikes, these risks multiply, often leading to longer hospital stays and higher mortality rates, particularly among seniors.

Emerging evidence underscores that preventing RSV in older adults can reduce serious respiratory illness and interrupt the inflammatory and haemodynamic stresses that can lead to heart failure. Recognising this, several medical bodies now recommend RSV vaccination for high-risk older adults. Malaysia has taken a significant step by approving RSV vaccines for those aged 50 and above, offering clinicians and families a practical tool to protect vulnerable populations before the high-risk monsoon season.

Understanding how RSV affects the heart helps clarify the importance of vaccination. The virus infects the airways, triggering an immune response that can cause inflammation, thicker secretions, and reduced oxygen levels. This places extra stress on the heart, potentially destabilising plaques or causing failure, especially in those aged 75 and above or with existing cardiovascular issues.

Given Malaysia’s high rates of hypertension, lipid disorders, and obesity, the need for proactive prevention becomes even clearer. RSV can be difficult to recognise and diagnose in seniors, making vaccination an essential layer of protection. As we approach World Heart Day 2025, it is imperative for policymakers to integrate adult RSV vaccination into national health strategies, for healthcare providers to routinely recommend it alongside other vaccines, and for families to discuss vaccination options with doctors, especially before the peak seasons.

Prevention works best when layered together, medications, healthy lifestyles, and targeted immunisation. Protecting older Malaysians from RSV is not just a fight against respiratory illness; it’s a vital step in safeguarding their hearts. This season, let us broaden our approach to heart prevention to include infections that threaten the fragile hearts of our seniors.