Abstract
BackgroundPersistent pathogens have been proposed as risk factors for stroke; however, the evidence remains inconclusive. Mexican Americans have an increased risk of stroke especially at younger ages, as well as a higher prevalence of infections caused by several persistent pathogens.Methodology/PrincipalFindings Using data from the Sacramento Area Latino Study on Aging (n = 1621), the authors used discrete-time regression to examine associations between stroke risk and (1) immunoglobulin G antibody levels to Helicobacter pylori (H. pylori), Cytomegalovirus, Varicella Zoster Virus, Toxoplasma gondii and Herpes simplex virus 1, and (2) concurrent exposure to several pathogens (pathogen burden), defined as: (a) summed sero-positivity, (b) number of pathogens eliciting high antibody levels, and (c) average antibody level. Models were adjusted for socio-demographics and stroke risk factors. Antibody levels to H. pylori predicted incident stroke in fully adjusted models (Odds Ratio: 1.58; 95% Confidence Interval: 1.09, 2.28). No significant associations were found between stroke risk and antibody levels to the other four pathogens. No associations were found for pathogen burden and incident stroke in fully adjusted models.Conclusions/SignificanceOur results suggest that exposure to H. pylori may be a stroke risk factor in Mexican Americans and may contribute to ethnic differences in stroke risk given the increased prevalence of exposure to H. pylori in this population. Future studies are needed to confirm this association.
Highlights
In the United States, stroke is a significant public health issue, affecting roughly 795,000 individuals annually [1]
Mexican Americans (MAs) have a higher prevalence of infections caused by several persistent pathogens that have been linked to chronic diseases, including Cytomegalovirus (CMV) [5], Helicobacter pylori (H. pylori) [6], Toxoplasma gondii (T. gondii) [7], and Herpes simplex virus 2 (HSV2) [8]
Using data from an elderly cohort of Latinos residing in Sacramento County, California, we found a significant association between Immunoglobulin G (IgG) antibody levels to H. pylori and incident stroke after adjusting for socio-demographics and stroke risk factors
Summary
In the United States, stroke is a significant public health issue, affecting roughly 795,000 individuals annually [1]. Mexican Americans (MAs) are among the fastest growing populations in the United States [2], and stroke incidence is higher in MAs than in Non-Hispanic whites (NHWs), especially at younger ages [3]. [11] Aside from exposure to individual pathogens, total pathogen burden, or exposure to multiple pathogens concurrently, may impact stroke risk by invoking a stronger immune system response than what would be apparent with exposure to a single persistent infection. Persistent pathogens, traditional risk factors, and genetic predisposition may work together in stimulating inflammatory pathways that promote atherosclerosis, which in turn may increase stroke risk [12]. Persistent pathogens have been proposed as risk factors for stroke; the evidence remains inconclusive. Mexican Americans have an increased risk of stroke especially at younger ages, as well as a higher prevalence of infections caused by several persistent pathogens
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