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Herpes zoster raises future risk of stroke in people under 40

Saturday January 4, 2014
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Having shingles may increase the risk of having a stroke years later, according to a British study.

People ages 18 to 40 who had acute herpes zoster were more likely to have a stroke, myocardial infarction or transient ischemic attack years later than people who had not had the virus, researchers reported Jan. 2 on the website of the journal Neurology. People over 40 who had herpes zoster were more likely to have a MI or TIA, but not a stroke.

The study involved 106,600 people who had herpes zoster and 213,200 people of similar ages who did not have the virus. Using a United Kingdom database, researchers reviewed the participants’ records for an average of six years after the HZ diagnosis and for as long as 24 years for some participants.

People younger than 40 were 74% more likely to have a stroke if they’d had herpes zoster, after adjusting for stroke risk factors such as obesity, smoking and high cholesterol. A total of 40 people with HZ (0.21%) had a stroke, compared with 45 of those who had not had HZ (0.12%). People under 40 were 2.4 times more likely to have a transient ischemic attack if they had HZ and 50% more likely to have a myocardial infarction.

The disparity was not as great in people over 40. They were 15% more likely to have a transient ischemic attack and 10% more likely to have a myocardial infarction if they had HZ.

Study author Judith Breuer, MD, of University College London, said that better screening and treatment for stroke risk factors — including diabetes, high cholesterol and hypertension — might explain why older people are at lower risk than younger subjects of stroke, transient ischemic attack and heart-related events following HZ.

“Anyone with shingles, and especially younger people, should be screened for stroke risk factors,” Breuer said in a news release. “The shingles vaccine has been shown to reduce the number of cases of shingles by about 50%. Studies are needed to determine whether vaccination can also reduce the incidence of stroke and heart attack. However, what is also clear is that factors that increase the risk of stroke also increase the risk of shingles, so we do not know if vaccinating people can reduce the risk of stroke per se.

“Current recommendations are that anyone 60 years and older should be vaccinated. The role for vaccination in younger individuals with vascular risk factors needs to be determined.”

Study: www.neurology.org/content/early/2014/01/02/WNL.0000000000000038.short


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