If you have heart disease, you should get an annual flu shot. That's the message put out by the American Heart Association and the American College of Cardiology. Studies have shown that death from the flu (influenza) is more common among people with cardiovascular disease than among people with any other chronic condition. Doctors have long recommended that older adults and other high-risk groups get flu shots, but are now placing more emphasis on the importance of flu shots for those with heart disease. The flu shot could prevent thousands of flu-related complications and deaths every year in people who have heart disease.

Larry Baddour, M.D., an infectious diseases specialist at Mayo Clinic and professor of medicine at Mayo Clinic College of Medicine, was on a joint American Heart Association and American College of Cardiology advisory panel that developed the recent recommendation. He shares his insight about the group's recommendation.

According to the Centers for Disease Control and Prevention (CDC), the flu is estimated to cause more than 36,000 deaths annually in the United States. In addition, it sends 225,000 people to the hospital. The rate of flu-related complications is even higher for people with heart disease.

If you have heart disease, you are at increased risk of complications from the flu — including pneumonia, respiratory failure, heart attack and death. Having the flu can also cause dehydration and worsen heart failure, diabetes or asthma.

Most scientific evidence indicates that flu shots are associated with a reduced risk of cardiovascular events — such as heart attack — in people with known cardiovascular disease.

Flu shots are safe for most people who have heart disease. Get your flu vaccine injected by needle, usually in the arm. Some people develop mild arm soreness at the injection site. The flu vaccine that is given by nasal spray isn't recommended for people with heart disease because it's made with live virus that can trigger flu symptoms in people with heart disease.

If you have heart disease, get the flu shot each fall when it becomes available, usually late September through November. However, if flu shots are still available and you haven't yet received a vaccination, you'd still benefit from getting a flu shot in January or later. That's because the flu season doesn't typically peak until January, February or March.

You don't have to get your flu shot from your cardiologist. However, the American Heart Association is recommending that cardiologists have the flu shot available at their clinics. The flu shot is also available through primary care doctors, some specialists and cardiology clinics, public health departments and some pharmacies. It's best to call ahead to determine if vaccine is available and when. Some places may require an appointment.