We all know shingles is unsightly, painful and can come with a number of side effects, but did you know it might also be bad for your heart?
A new study from researchers at the University College London, and published online this week in the Official Journal of the American Academy of Neurology, finds a significant correlation between young people who have had herpes zoster, otherwise known as shingles, and their developing heart disease and heart attacks in later life.
Shingles is a recurrence of the herpes zoster virus, the same virus that causes that childhood scourge chickenpox. When a child recovers from a chickenpox infection, the virus is not completely eradicated from the body and can remain dormant in the nerve roots. The virus can reassert itself years later, often as a result of having a compromised immune system, and this causes a painful rash that characteristically occurs on only one side of the body (usually on the torso). Shingles can also affect vision by compromising the optic nerve, among other complications.
The researchers in this latest study into shingles looked at data from 106,600 people who had shingles and 213,200 people who did not have shingles. All were of similar ages and lifestyles, and were tracked over a period of six years up to 24 years using data gleaned from UK public health records.
What the researchers found was quite marked. Those under 40 who had developed shingles were 74% more likely to have a stroke even after adjusting for known risk factors like being obese and smoking. People under 40 who had developed shingles at some point were also more likely to have a transient ischaemic attack (TIA) or “mini stroke,” and were also 50% more likely to have a heart attack.
In people who had shingles after 40, the link was not as pronounced but was still arguably significant. The researchers found they were 15% more likely to have a TIA and around 10% more likely to have a heart attack when compared to those who had never developed shingles.
Lead researcher Judith Breuer, MD, of University College London, said this research points to a need for screening shingles sufferers and examining their heart health. She also suggests it indicates there is a clear need to increase awareness about the shingles vaccine while investigating whether it’s time we begin giving the vaccine to younger people:
“Anyone with shingles, and especially younger people, should be screened for stroke risk factors,” Breuer is quoted as saying. “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. 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.”
It’s important to stress that this research, which was supported by the National Institute for Health Research and Sanofi Pasteur MSD, the European maker of the shingles vaccine, does not establish a causal link between developing shingles and having a heart attack in later life.
However, the study does present strong grounds for further investigation into why it might be that shingles sufferers appear to be at a markedly increased risk of heart attacks and other heart problems. This isn’t the first study to suggest that shingles may lead to other health problems, either, with previous research suggesting that shingles can increase the risk of developing Multiple Sclerosis.
Shingles is not of itself highly contagious and to contract the herpes zoster virus from someone with shingles you would need to come into direct contact with the fluid from the shingles rash. However, the initial chickenpox infection is of course very easily spread and as a result most people in their lifetime will probably contract the herpes zoster virus. Shingles mainly affects those over the age of 50 and is rare among children.
Currently, the shingles vaccine Zostavax is only given to those 60 years or older in the USA, with ages differing throughout Europe. The vaccine has been shown to help prevent shingles developing and is effective in 50% of cases or more depending on age and other health factors. Even in those patients who do go on to develop a shingles flare up, there is evidence to suggest that the vaccine can prevent or ease shingles complications like Postherpetic neuralgia (PHN), a painful disorder which can result from a shingles attack and last for months or even years after the shingles outbreak.
If you suspect you may have shingles, talking with your doctor as early as possible is important because there are medications that, while they cannot prevent shingles progressing, can ease symptoms and further reduce the risk of PHN.
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