Is Human Cytomegalovirus Infection Associated with Hypertension? The United States National Health and Nutrition Examination Survey 1999–2002

Chao Li,Hoi Kin Wong,Kwok Leung Ong,Bernard M Y Cheung,Nithushi R Samaranayake,Weili Zhang

doi:10.1371/journal.pone.0039760

Abstract

PurposeRecent studies have implicated the human cytomegalovirus (HCMV) as a possible pathogen for causing hypertension. We aimed to study the association between HCMV infection and hypertension in the United States National Health and Nutrition Examination Survey (NHANES).MethodsWe analyzed data on 2979 men and 3324 women in the NHANES 1999–2002. We included participants aged 16–49 years who had valid data on HCMV infection and hypertension.ResultsOf the participants, 54.7% had serologic evidence of HCMV infection and 17.5% had hypertension. There were ethnic differences in the prevalence of HCMV infection (P<0.001) and hypertension (P<0.001). The prevalence of both increased with age (P<0.001). Before adjustment, HCMV seropositivity was significantly associated with hypertension in women (OR = 1.63, 95% CI = 1.25–2.13, P = 0.001) but not in men. After adjustment for race/ethnicity, the association between HCMV seropositivity and hypertension in women remained significant (OR = 1.55, 95% CI = 1.20–2.02, P = 0.002). Further adjustment for body mass index, diabetes status and hypercholesterolemia attenuated the association (OR = 1.44, 95% CI = 1.10–1.90, P = 0.010). However, after adjusting for age, the association was no longer significant (OR = 1.24, 95% CI = 0.91–1.67, P = 0.162).ConclusionsIn this nationally representative population-based survey, HCMV seropositivity is associated with hypertension in women in the NHANES population. This association is largely explained by the association of hypertension with age and the increase in past exposure to HCMV with age.

Highlights

Hypertension, a multi-factorial disease, is a global public health burden. [1,2] It is a predisposing risk factor for myocardial infarction, revascularization, heart failure, stroke and renal failure
[6] Human cytomegalovirus (HCMV) infection is usually asymptomatic in healthy adults, it can infect organs and tissues virtually throughout the body
[13] As hypertension is an important cause of cardiovascular diseases (CVDs), we studied the association between HCMV and hypertension in the United States (US) National Health and Nutrition Examination Survey (NHANES) 1999–2002

Summary

Introduction

Hypertension, a multi-factorial disease, is a global public health burden. [1,2] It is a predisposing risk factor for myocardial infarction, revascularization, heart failure, stroke and renal failure. [1,2] It is a predisposing risk factor for myocardial infarction, revascularization, heart failure, stroke and renal failure. Both genetic and environmental factors are involved in the development of hypertension. [6] HCMV infection is usually asymptomatic in healthy adults, it can infect organs and tissues virtually throughout the body. HCMV is a cause of congenital diseases, causes primary infection in children and young adults, and has been implicated in pneumonitis, retinitis and gastroenteritis in adults, in immunosuppressed or immunocompromised patients, such as transplant recipients and patients with HIV infection. HCMV is a cause of congenital diseases, causes primary infection in children and young adults, and has been implicated in pneumonitis, retinitis and gastroenteritis in adults, in immunosuppressed or immunocompromised patients, such as transplant recipients and patients with HIV infection. [7]

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