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Abstract
BackgroundAcute and agent-specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections on cardiovascular disease is limited. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD).MethodsIn a cross-sectional study, we assessed the relation of recurrent infections and carotid artery intima-media thickness (IMT) in 1946 disease-free women from the Mexican Teachers’ Cohort. Through 2012–2016, participants answered structured questions on respiratory, urinary and vaginal infections during the previous year and their IMT was measured using ultrasound by standardized neurologists. We defined sCVD as mean right and left IMT ≥0.8 mm or the presence of atheromatous plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting for age, sociodemographic, and cardiovascular risk factors.ResultsAmong participants (50±5 years) 13% reported no infections, 20% one infection and 67% three or more episodes. Overall prevalence of sCVD was 12%(n = 240). Adjusted models for logistic regression showed that women with 2 or more infections had 91% higher odds of sCVD (OR 1.91; 95%CI 1.16, 3.13) compared to women without infections (p-trend:0.015). Sub-analyses by type of infection resulted not significant. Linear regression analysis did not show a significant association between mean IMT and recurrent infections.ConclusionsRecurrent infectious events in young adult women are associated with greater sCVD, which supports the hypothesis of low-grade chronic inflammation in the pathophysiology of cardiovascular disease.
Highlights
Inflammation is associated with atherosclerosis, which increases the risk of cardiovascular events [1]
Adjusted models for logistic regression showed that women with 2 or more infections had 91% higher odds of subclinical cardiovascular disease (sCVD) compared to women without infections (p-trend:0.015)
Recurrent infectious events in young adult women are associated with greater sCVD, which supports the hypothesis of low-grade chronic inflammation in the pathophysiology of cardiovascular disease
Summary
Inflammation is associated with atherosclerosis, which increases the risk of cardiovascular events [1]. Infections have been determined to increase the risk of cardiovascular diseases, including acute myocardial infarction, ischemic stroke and atherosclerosis [3,4,5]. Respiratory [10], cytomegalovirus [11], tuberculosis [12], and influenza infections [13,14,15], have been associated with acute and long-term risk of myocardial infarction [16]. Higher risk of ischemic stroke [10, 17, 18] has been found in patients with tuberculosis [19], influenza [20], respiratory [10], cytomegalovirus and herpesvirus simplex [21, 22] infections. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD)
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