HPV in women may contribute to risk for heart disease death
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Key takeaways:
- High-risk HPV infection nearly quadrupled risk for heart disease-related death in women.
- Obesity was a risk modifier, increasing the association between HPV infection and CV mortality.
South Korean women positive for high-risk HPV infection were nearly four times as likely to die of atherosclerotic CVD compared with women without HPV infection, even when women had no baseline CVD and low CV risk factors, data show.
“Despite remarkable advances in controlling well-known risk factors for heart disease such as smoking, high cholesterol, hypertension and diabetes, heart disease continues to be a major cause of death,” Seungho Ryu, MD, PhD, of Sungkyunkwan University School of Medicine in Seoul, South Korea, said in a press release. “Interestingly, these conventional risk factors do not explain all heart disease cases; about 20% occur in people who do not have these issues. This highlights the need to investigate other changeable risk factors. Our research focuses on examining the impact of HPV, particularly in relation to CV mortality, as a potential risk factor for heart disease.”
Data were derived from Cheong HS, et al. Eur Heart J. 2024;doi:10.1093/eurheartj/ehae020.
Risks with infection
In a prospective study, Ryu and colleagues analyzed data from 163,250 women aged 30 years or older living in South Korea with no known ASCVD who were tested for high-risk cancer from HPV infection and followed for a median of 8.6 years. The mean age of women at baseline was 40 years, and the prevalence of CV risk factors in the cohort was low overall, with less than 4.7% reporting smoking, fewer than 6.8% reporting hypertension, fewer than 2.3% reporting diabetes and fewer than 2.6% prescribed lipid-lowering therapy. Researchers followed women through 2020 using nationwide death data from the Korea National Statistical Office. The primary outcome was CVD mortality.
Within the cohort, 9.2% of women were positive for high-risk HPV.
During 1,380,953 person-years of follow-up, there were 134 CV deaths, of which 16% occurred in women with a high-risk HPV infection.
The mortality rate was 9.1 per 100,000 person-years for HPV-negative women and 14.9 per 100,000 person-years for HPV-positive women. In analyses adjusted for traditional CV risk factors, HRs for women with HPV infection were 3.91 for ASCVD-related death (95% CI, 1.85-8.26), 3.74 for ischemic heart disease-related death (95% CI, 1.53-9.14) and 5.86 for stroke death (95% CI, 0.86-40.11) compared with HPV-negative women.
Researchers found that the association between HPV infection and any CV-related death strengthened significantly for women with obesity, with HRs of 4.81 for women with obesity and HPV infection (95% CI, 1.55-14.93) vs. 2.86 for women with HPV infection but no obesity (95% CI, 1.04-7.88; P for interaction = .006).
“If these findings are confirmed, they could have substantial implications for public health strategies,” Ryu said in the release. “Increasing HPV vaccination rates may be an important strategy in reducing long-term CV risks.”
‘Strong case’ for viruses as CV risk factors
In a related editorial published in European Heart Journal, Noel C. Chan, MD, assistant professor in the division of hematology and thromboembolism at McMaster University, and colleagues wrote that the data show the importance of counseling women — including those who are healthy and without CV risk factors — to consider getting vaccinated against viruses such as HPV, influenza and SARS-CoV-2.
“The evidence that viruses in general and HPV in particular increase the risk of adverse outcomes from ASCVD has become compelling enough to add to the already strong case for vaccination against influenza virus, SARS-CoV-2 and HPV,” Chan and colleagues wrote. “The evidence that HPV is causal in the initiation or progression of ASCVD is highly suggestive but would become definitive if the results of randomized trials evaluating HPV vaccines for prevention of cervical cancer showed a reduction in ASCVD.
“These findings, when added to other evidence linking HPV and other viruses to higher CVD mortality, make a strong case for accepting viruses as risk factors for adverse outcomes from ASCVD,” Chan and colleagues wrote.
Reference:
- Chan NC, et al. Eur Heart J. 2024;doi:10.1093/eurheartj/ehad829.
- Women with HPV infection face higher risk of death from cardiovascular disease. https://www.eurekalert.org/news-releases/1033238. Published on Feb. 6, 2024. Accessed on Feb. 6, 2024.
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