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May 1, 1994Heart663 citationsOpen Access

Relation of Helicobacter pylori infection and coronary heart disease.

MMMichael A. MendallPGPatrick GogginNMN. Molineaux

Key Points

  • To determine whether chronic infection with Helicobacter pylori, typically acquired in childhood, is associated with an elevated risk of coronary heart disease in adulthood.
  • Case-control study involving 111 consecutive white male cases with documented coronary heart disease (aged 45–65) from a cardiology clinic and 74 controls from a health screening clinic.
  • Serum samples were evaluated for H pylori-specific IgG antibodies using ELISA (98% sensitivity, 94% specificity).
  • Multiple logistic regression adjusted for age, cardiovascular risk factors, social class, and childhood environmental markers.
  • H pylori seropositivity was present in 59% of cases versus 39% of controls (OR 2.28, chi-square 7.35, p = 0.007).
  • Adjustment for age, cardiovascular risk factors, and social class maintained a significant association (OR 2.15, p = 0.03), which remained elevated after adjusting for childhood environment (OR 1.9).
  • H pylori seropositivity did not correlate with traditional cardiovascular risk factors within the control group.

Abstract

BACKGROUND: There is evidence suggesting that early life experience may influence adult risk of coronary heart disease (CHD). Chronic bacterial infections have been associated with CHD. OBJECTIVE: To determine whether Helicobacter pylori, a childhood acquired chronic bacterial infection, is associated with an increased risk of coronary heart disease in later life. DESIGN: Case-control study controlling for potential confounding variables with an opportunistically recruited control group. SUBJECTS: 111 consecutive cases with documented CHD were recruited from a cardiology clinic and 74 controls from a general practice health screening clinic. All were white men aged 45-65. METHODS: Serum was analysed for the presence of H pylori specific IgG antibodies by ELISA (98% sensitive and 94% specific for the presence of infection). RESULTS: 59% of the cases and 39% of the controls were seropositive for H pylori (odds ratio 2.28, chi 2 7.35, p = 0.007). After adjustment by multiple logistic regression for age, cardiovascular risk factors, and current social class, the effect of H pylori was little altered (odds ratio 2.15, p = 0.03). Further adjustment for various features of the childhood environment known to be risk factors for H pylori infection only slightly weakened the association (odds ratio 1.9). H pylori seropositivity was not related to the level of risk factors in the control population. CONCLUSION: In this pilot study the association of adult coronary heart disease with H pylori seropositivity suggests that the early childhood environment may be important in determining the risk of CHD in adult life. The association needs confirmation in other better designed studies. If H pylori itself is responsible for the association, then this is of great potential importance as the infection is treatable.

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Cite This Study

Mendall et al. (1994) studied this question.

synapsesocial.com/papers/6a0f79f1fb2817e31dfcacc4https://doi.org/10.1136/hrt.71.5.437
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