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Relation of Helicobacter pylori infection and coronary heart disease
M A Mendall1, P M Goggin, N Molineaux
1Department of Medicine, St Georges Hospital Medical School, Tooting, London.
Insights
Helicobacter pylori infection in childhood may increase the risk of developing coronary heart disease (CHD) later in life. This association suggests early life factors influence adult cardiovascular health.
Area of Science:
- Cardiovascular epidemiology
- Infectious disease research
- Public health
Background:
- Early life experiences are linked to adult coronary heart disease (CHD) risk.
- Chronic bacterial infections have been associated with CHD development.
Purpose of the Study:
- To investigate the association between Helicobacter pylori (H. pylori), a common childhood infection, and increased risk of coronary heart disease (CHD).
Main Methods:
- A case-control study involving 111 men with CHD and 74 controls (aged 45-65).
- Serum samples were analyzed for H. pylori specific IgG antibodies using ELISA.
- Statistical analysis controlled for confounding variables like age and cardiovascular risk factors.
Main Results:
- 59% of CHD cases and 39% of controls were seropositive for H. pylori (OR=2.28, p=0.007).
- The association remained significant after adjusting for multiple risk factors (adjusted OR=2.15, p=0.03).
- Childhood environmental factors associated with H. pylori infection only slightly weakened the observed link.
Conclusions:
- This pilot study suggests a potential link between H. pylori seropositivity and adult coronary heart disease.
- The findings highlight the importance of early life environment in determining adult CHD risk.
- Further research is needed to confirm these results and explore H. pylori's role, given its treatability.
Background:
There is evidence suggesting that early life experience may influence adult risk of coronary heart disease (CHD). Chronic bacterial infections have been associated with CHD.
Objective:
To determine whether Helicobacter pylori, a childhood acquired chronic bacterial infection, is associated with an increased risk of coronary heart disease in later life.
Design:
Case-control study controlling for potential confounding variables with an opportunistically recruited control group.
Subjects:
111 consecutive cases with documented CHD were recruited from a cardiology clinic and 74 controls from a general practice health screening clinic. All were white men aged 45-65.
Methods:
Serum was analysed for the presence of H pylori specific IgG antibodies by ELISA (98% sensitive and 94% specific for the presence of infection).
Results:
59% of the cases and 39% of the controls were seropositive for H pylori (odds ratio 2.28, chi 2 7.35, p = 0.007). After adjustment by multiple logistic regression for age, cardiovascular risk factors, and current social class, the effect of H pylori was little altered (odds ratio 2.15, p = 0.03). Further adjustment for various features of the childhood environment known to be risk factors for H pylori infection only slightly weakened the association (odds ratio 1.9). H pylori seropositivity was not related to the level of risk factors in the control population.
Conclusion:
In this pilot study the association of adult coronary heart disease with H pylori seropositivity suggests that the early childhood environment may be important in determining the risk of CHD in adult life. The association needs confirmation in other better designed studies. If H pylori itself is responsible for the association, then this is of great potential importance as the infection is treatable.