Helicobacter pylori is now incriminated in the pathogenesis
To examine the importance of H. pylori infection as a
cardiovascular disease (CVD) risk factor.
Two hundred five patients (128 with H. pylori infection
[HP-seropositive] and 77 without) had a baseline assessment
for other potential CVD risk factors and were followed prospectively for 10
years (1999–2008). They were assessed on a monthly basis for the
outcomes of carotid plaque, angina pectoris, myocardial infarction, and
stroke. In the HP-seropositive group, male sex and quartile 4 for IgG
anti-H. pylori antibodies (anti-HP Ab) were correlated
with traditional CVD risk factors, stroke, myocardial infarction, and angina
At the baseline assessment, the levels of carotid intima-media thickness,
blood fibrinogen, total cholesterol, fasting plasma glucose, and uric acid
were higher in H. pylori-infected patients than in the
uninfected group. Serum HDL-cholesterol was significantly lower in the
HP-seropositive group. Men had higher levels of IgG anti-HP Ab, waist
circumference, blood pressure, uric acid, and total cholesterol than women.
Within the HP-seropositive group, individuals in quartile 4 for IgG anti-HP
Ab had higher rates of elevated fibrinogen, diabetes mellitus, low
high-density lipoprotein cholesterol, arterial hypertension, and high total
cholesterol than those in quartile 1. After adjusting for traditional CVD
risk factors, H. pylori infection was the only independent
predictor of incident carotid plaque (multivariate odds ratio
[OR] = 2.3, 95% confidence interval
[CI]: 1.2–7.2; P < 0.0001) and
incident acute stroke (multivariate OR = 3.6, 95% CI:
1.4–8.2; P < 0.0001). Within the HP-seropositive
group and after adjusting for traditional CVD risk factors, male sex was the
only independent predictor of incident angina pectoris (multivariate OR
= 3.5, 95% CI: 1.6–16; P <
0.0001), incident acute stroke (multivariate OR = 3.2, 95%
CI: 1.4–28; P < 0.0001), and acute myocardial
infarction (multivariate OR = 7.2, 95% CI: 3.1–18;
P < 0.0001).
Our study provides evidence for an association among known CVD risk factors,
carotid plaque, stroke, and H. pylori infection. Among
infected individuals, there is a significant association among severity of
HP-seropositivity, male sex, and CVD. The eradication of H.
pylori infection may therefore reduce the emerging burden of
CVD in Africa.