Shingles linked to higher risk of heart attack and stroke

BOSTON — Shingles, the painful rash-like condition also known as herpes zoster, appears to also increase a patient’s long-term risk of suffering a stroke or heart attack. Researchers from Brigham and Women’s Hospital say that this risk may last 12 or more years after a shingles outbreak.

Shingles is caused by the varicella zoster virus, just like chicken pox. By age 50, most people in the U.S. contract chicken pox, subsequently putting them at a greater risk of developing shingles. The disease often presents itself as a painful rash that can occur anywhere on the body or head. Around one in three people will develop shingles, likely with age and in those more susceptible due to a weakened immune system related to disease or medication use.

Given the prevalence of the infection, scientists are racing to improve preventative health care measures.

“Given the growing number of Americans at risk for this painful and often disabling disease and the availability of an effective vaccine, shingles vaccination could provide a valuable opportunity to reduce the burden of shingles and reduce the risk of subsequent cardiovascular complications,” says lead author Sharon Curhan, MD, ScM, a physician and epidemiologist in the Channing Division of Network Medicine at Brigham and Women’s Hospital, in a media release.

Most commonly, a shingles infection leads to postherpetic neuralgia — a burning pain that persists even after the shingles rash goes away. Moreover, evidence continues to mount showing that reactivation of the virus can lead to even more serious complications such as stroke or coronary artery disease. The virus has been found in both large and small blood vessels, which can result in chronic changes to vasculature and inflammation that can heighten a person’s risk of blood vessel blockages and blood flow restriction.

Shingles outbreaks can increase heart disease risk by a third

To examine this, the investigators conducted a prospective, longitudinal review including over 200,000 men and women from three large cohort studies. The team collected data on shingles, stroke, and coronary heart disease through questionnaires every two years, confirming diagnoses with each person’s medical records.

None of the participants had a prior history of stroke or coronary artery disease. Researchers followed up with the participants for up to 16 years, examining if any were at a higher risk of having a stroke or developing heart disease after a shingles outbreak.

Results show that people with shingles previously had a 30-percent higher long-term risk of having a major cardiovascular event compared to those who didn’t have shingles, and that risk lasted 12 or more years.

“Our findings suggest there are long-term implications of shingles and highlight the importance of public health efforts for prevention,” says Curhan.

The researchers mention that a key limitation to their work is that much of it was completed prior to the shingles vaccine becoming widely available. Even after it did, however, they say not many patients opted to get the vaccine. Therefore, the team wasn’t able to consider how vaccination status impacted the link between shingles and cardiovascular disease. In the future, Curhan and the team hope to study this relationship further.

“We are currently collecting vaccination information among our participants and hope to conduct these studies in the future,” the study author concludes.

The findings are published in the Journal of the American Heart Association.

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