Shingles Ups Risk of Stroke and Heart Attack

Shingles, or herpes zoster, has been identified as an independent risk factor for stroke, warning stroke, and heart attacks, in individuals affected by the virus prior to the age of 40 years, according to a new study released by Neurology®. Consequently, lead study author Dr. Judith Breuer suggests, “Anyone with shingles, and especially younger people, should be screened for stroke risk factors,” reports CNN.

Method. The study reviewed 106,602 shingles cases, and 213,202 controls within the Health Improvement Network general practice database. Researchers then examined the risk of stroke, transient ischemic attack (warning stroke), and hard attack in both groups for up to 24 years after the occurrence of shingles. Results were adjusted to account for vascular risk factors, including heightened body mass indexes, smoking, high cholesterol, hypertension, diabetes, heart disease, and others.

Findings.  Case subjects who contracted shingles under the age of 40 years were found to be 74 percent more likely to have a stroke, after accounting for other vascular risks. In addition, the same group was found to be 50 percent more likely to have a heart attack, and 2.4 times more likely to have a warning stroke after contracting shingles, reported CNN. However, those who contracted shingles over the age of 40 were only 15 percent more likely to have a warning stroke and 10 percent more likely to have a heart attack than the control group. The study suggests that lower numbers of strokes for shingles patients above the age of 40 may be attributable to better ascertainment of vascular risk factors and earlier intervention due to standard medical checkups conducted at that age.

Lead author Dr. Jiunn-Horng Kang noted, “Many studies have shown that people with herpes zoster infection are more likely to develop stroke, but ours was the first to demonstrate the actual risk of stroke following herpes zoster infection,” according to CNN.

In an interview with CNN, Virginia Heart chief medical officer Dr. Warrant Levy noted, “Although it’s still unknown why herpes zoster can cause stroke and heart problems, I am guessing it highlights the role of viral infections, like shingles and the cause of inflammation to the circulatory system.” Levy continued, “We already know inflammation can cause serious heart problems. Perhaps we need to be extremely vigilant, especially with those who have been infected with shingles, and treat them more aggressively for heart attack and stroke prevention, no matter what age they became infected.”

According to the CDC, a shingles vaccine is available to reduce the risk of the virus, and is recommended for people at or above 60 years of age. However, given the increased risk of stroke, warning stroke, and heart attack in shingles patients under the age of 40, Dr. Levy poses the question, “should younger people be getting the vaccine?”

Dr. Breuer suggests, “The shingles vaccine has been shown to reduce the number of cases of shingles by about 50 percent. Studies are needed to determine whether vaccination can also reduce the incidence of stroke and heart attack,” according to CNN.