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Shingles associated with a higher long-term risk of major cardiovascular events
A new study by researchers at Brigham and Women's Hospital, a founding member of the Mass General Brigham Health System, showed that shingles, also known as herpes zoster, is associated with a nearly 30% higher long-term risk of a major cardiovascular event such as a stroke or heart attack. Their results will be published in the Journal of the American Heart Association. Our results suggest that shingles has long-term effects and highlight the importance of public health efforts for prevention. Given the growing number of Americans at risk of this painful and often disabling disease and the availability of an effective...
Shingles associated with a higher long-term risk of major cardiovascular events
A new study by researchers at Brigham and Women's Hospital, a founding member of the Mass General Brigham Health System, showed that shingles, also known as herpes zoster, is associated with a nearly 30% higher long-term risk of a major cardiovascular event such as a stroke or heart attack. Their results will be published in the Journal of the American Heart Association.
Our results suggest that shingles has long-term effects and highlight the importance of public health efforts for prevention. Given the growing number of Americans at risk of this painful and often disabling disease and the availability of an effective vaccine, shingles vaccination may provide a valuable opportunity to reduce the burden of shingles and reduce the risk of subsequent cardiovascular complications.”
Sharon Curhan, MD, ScM, lead author, physician and epidemiologist in the Channing Division of Network Medicine at Brigham and Women's Hospital
Shingles often causes a painful rash and can appear anywhere on the head or body. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person has chickenpox, the virus remains in their body for the rest of their life. Years and even decades later, the virus can reactivate as shingles. Almost everyone in the United States ages 50 and older has been infected with the chickenpox virus and is therefore at risk for shingles.
About 1 in 3 people will develop shingles during their lifetime, with more cases predicted as the population ages and more people have compromised immunity due to illness or medication use.
The most common complication of shingles is postherpetic neuralgia. This condition affects nerve fibers and skin and causes burning pain that lasts long after the shingles rash and blisters have disappeared. However, there is growing evidence that reactivation of the virus can have even longer-lasting side effects. The virus may play a role in the development of cardiovascular disease, including stroke and coronary heart disease. The virus has been detected in large and small blood vessels, which can cause inflammation and chronic vascular changes over time. These changes can increase the risk of blood vessel blockages, restricted blood flow, and cardiovascular events such as strokes and heart attacks.
The prospective longitudinal study followed three large US cohorts with more than 200,000 women and men: the Nurses' Health Study (~79,000 women), the Nurses' Health Study II (~94,000 women) and the Health Professionals Follow-Up Study (~31,000 men). Participants had no history of stroke or coronary heart disease. The team collected information on shingles, stroke and coronary artery disease using questionnaires collected every two years and confirmed the diagnoses by reviewing medical records. The team followed participants for up to 16 years and assessed whether those who had shingles had a higher risk of a stroke or coronary heart disease years after the shingles episode.
Researchers tracked the incidence of stroke and coronary artery disease - defined as nonfatal or fatal myocardial infarction (heart attack) or a coronary revascularization procedure (CABG, coronary artery bypass graft, or percutaneous transluminal coronary angioplasty). The researchers also evaluated a composite cardiovascular disease outcome that included either stroke or coronary artery disease, whichever came first.
The results showed that people who had previously had shingles had a 30% higher long-term risk of a major cardiovascular event than those who had not had shingles, and the increased risk can persist for 12 years or longer after having shingles.
Due to time constraints, much of the study took place before shingles vaccines became widely available. Even after their introduction, uptake of vaccinations was generally low. Because of these limitations, researchers could not assess whether vaccination status might influence the association of shingles and the long-term risk of a major cardiovascular event.
As more people choose to receive the shingles vaccine, future studies could examine whether vaccination influences the relationship between shingles and cardiovascular disease risk. Curhan added: “We are currently collecting vaccination information among our participants and hope to conduct these studies in the future.”
Source:
Reference:
Curhan, SG, et al. (2022) Herpes zoster and the long-term risk of cardiovascular disease. Journal of the American Heart Association. doi.org/10.1161/JAHA.122.027451.
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