High-risk HPV in women increases risk of death from heart disease

Women infected with high-risk types of human papillomavirus (HPV) have a much higher risk of dying from certain types of cardiovascular disease (CVD), a prospective cohort study from South Korea has found.

Compared to women without high-risk strains, women infected with high-risk HPV were more likely to have atherosclerotic CVD (ASCVD; HR 3.91, 95% CI 1.85-8.26) and ischemic heart disease (HR 3.74, 95 ), the risk of death from both was more than three times higher. % CI 1.53-9.14), Yoosoo Chang, MD, of Gangbuk Samsung Hospital in Seoul, South Korea, and his colleagues reported.

And as they explained in it, european heart journalthe high risk of death from ASCVD in high-risk HPV patients was even higher when overweight or obesity was also a factor (P=0.006 (for interaction):

• If overweight or obese: HR 4.81 (95% CI 1.55-14.93)
• Without overweight or obesity: HR 2.86 (95% CI 1.04-7.88)

“HPV is primarily known for its role in causing cervical and other cancers, so by uncovering its significant impact on cardiovascular mortality, we can help clarify the systemic impact of this virus.” It opens up new avenues of understanding,” said co-author Hae Suk Cheong, MD, Ph.D., a native of Gangbuk. Samsung Hospital said. today’s med page on mail.

“This knowledge is critical for healthcare providers because it highlights the importance of considering high-risk HPV status in a patient’s overall cardiovascular risk assessment,” Cheong said.

In their analysis, researchers adjusted for CVD risk factors and other potential confounders, including triglycerides, LDL and HDL cholesterol, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and high-sensitivity C-cholesterol. We used a model that gave similar results when considering Reactive protein.

“These findings, when combined with other evidence linking HPV and other viruses with high CVD mortality, support the acceptance of viruses as a risk factor for adverse outcomes from ASCVD,” said James Lawson, MD, from the University of New South Wales. “This is strong evidence that this is the case.” Sidney and his colleagues stated in an accompanying editorial:

According to the editors, there are two mechanisms that could explain how HPV infection contributes to CVD: “First, the virus directly invades atherosclerotic plaques, thereby slowing plaque progression and Second, the virus can trigger a systemic inflammatory response, leading to CVD’ acute prothrombotic changes by activating platelets or blood clotting ability. ”

“The evidence that viruses in general, and HPV in particular, increase the risk of adverse outcomes from ASCVD is sufficiently convincing to add to the already strong case for vaccination against influenza virus, SARS-CoV-2, and HPV. “There is,” Lawson and colleagues commented. -author.

The study by Chang et al. included 163,250 Korean women aged 30 and older (mean age 40) who underwent high-risk HPV testing. Of these, 9% had high-risk HPV. Women with a history of CVD, malignancy, or hysterectomy were excluded from the study. Participants underwent a variety of health screening tests, including cervical screening for 13 high-risk HPV strains.

They come back for checkups every 1-2 years. At baseline, women had a lower prevalence of traditional CVD risk factors such as smoking, diabetes, hypertension, and use of lipid-lowering therapy. The researchers combined data on HPV test results with national records on CVD deaths.

A total of 134 CVD deaths occurred during a median follow-up of 8.6 years, with some women being followed for as long as 17 years. The authors found that absolute mortality rates were low in this relatively young population of women with few CVD risk factors, with mortality rates of 14.9 and 9.1 per 100,000 person-years for women with and without high-risk HPV, respectively. he pointed out.

Overall, the researchers found that women with high-risk HPV had an increased risk of death from CVD (HR 1.68, 95% CI 1.04-2.72), but there was no significant difference between high-risk HPV and death from ischemic stroke. No significant association was found (HR 5.86, 95%). CI 0.86-40.11), or other forms of her CVD if her ASCVD was excluded (HR 1.07, 95% CI 0.55-2.06).

Two important limitations of this study are that it did not include data on HPV vaccination status or specific HPV genotypes among vaccinated women.