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Helicobacter pylori infection and mortality from ischaemic heart disease: negative result from a large, prospective
N J Wald1, M R Law, J K Morris
1Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St Bartholomew's, London. nj.wald@mds.qmw.ac.uk
Insights
This study found no link between Helicobacter pylori infection and ischemic heart disease. While H. pylori is linked to stomach cancer, it does not appear to increase heart disease risk.
Area of Science:
- Cardiovascular epidemiology
- Gastroenterology
- Infectious diseases
Background:
- Helicobacter pylori (H. pylori) infection is a known risk factor for gastric cancer.
- The potential association between H. pylori and ischemic heart disease (IHD) remains a subject of investigation.
Purpose of the Study:
- To investigate the independent association between H. pylori infection and the risk of developing ischemic heart disease.
Main Methods:
- A nested case-control study was conducted using serum samples from 648 men who died from IHD and 1296 age-matched controls.
- IgG antibody titers specific to H. pylori were measured.
- The study included 21,520 professional men aged 35-64 examined between 1975 and 1982.
Main Results:
- The odds of death from IHD in men with H. pylori infection were not significantly different from those without infection (odds ratio 1.06; 95% CI 0.86-1.31).
- Plasma fibrinogen levels were similar in H. pylori positive and negative individuals.
- The study confirmed the association between H. pylori and stomach cancer (odds ratio 4.0; P < 0.001).
Conclusions:
- This large-scale study found no evidence of an independent association between H. pylori infection and ischemic heart disease.
- The findings suggest that H. pylori eradication may reduce stomach cancer incidence but is unlikely to prevent IHD.
Objective:
To determine whether there is an independent association between Helicobacter pylori infection of the stomach and ischaemic heart disease.
Design:
Prospective study with measurement of IgG antibody titres specific to H pylori on stored serum samples from 648 men who died from ischaemic heart disease and 1296 age matched controls who did not (nested case-control design).
Subjects:
21,520 professional men aged 35-64 who attended the British United Provident Association (BUPA) medical centre in London between 1975 and 1982 for routine medical examination.
Main Outcome Measure:
Death from ischaemic heart disease.
Results:
The odds of death from ischaemic heart disease in men with H pylori infection relative to that in men without infection was 1.06 (95% confidence interval 0.86 to 1.31). In a separate group of 206 people attending the centre, plasma fibrinogen was virtually the same in those who were positive for H pylori (2.62 g/l) and those who were negative (2.64 g/l).
Conclusions:
A study that by its size and design minimised both random error and socioeconomic bias found no relation between H pylori infection and ischaemic heart disease. The validity of the study was shown by its confirmation of the recognised association between H pylori infection and stomach cancer (odds ratio 4.0 (1.9 to 8.2); P < 0.001). Eradication of H pylori infection may greatly reduce the incidence of stomach cancer, one of the most common causes of death from cancer worldwide, but it cannot be expected to have any effect in preventing ischaemic heart disease.