A large study from the United Kingdom that looked at patients who had experienced one shingles attack found that the risks for future heart attack or stroke were increased if the patient was younger than 40 when they had shingles. The results of the study, titled Herpes zoster as a risk factor for stroke and TIA, were published on-line in the journal Neurology. In contrast, the study found that patients who experienced their first shingles attack after age 40 had no increased risk for a vascular event.
The UK study looked at the health records of hundreds of thousands of patients. Patients who had shingles before age 40 were found to be at a much higher risk for stroke, TIA or myocardial infarction (MI). The risks for a TIA, transient ischemic attack or mini-stroke, were highest at 2.4 times the general population. The risk of a stroke was found to be 1.7 times normal while that for an MI or heart attack were 1.5 times higher.
Shingles is a recurrence of an infection by the varicella zoster virus, which also causes chickenpox. Anyone who has had chickenpox may have a future case of shingles. While the infection can appear at any age, it is most common in the elderly. The Centers for Disease Control estimate that nearly one out of three Americans will develop shingles in their lifetime. The National Institutes of Health states that 50 percent of all Americans will have had a case of shingles by age 80.
There is a shingles vaccine approved for patients age 60 and older. It may prevent the illness or reduce the severity of the infection if one occurs. The CDC states that studies have shown that 99 percent of all Americans over age 40 have had chickenpox, and could have shingles at some point in their lives. A chickenpox vaccine exists and at least 36 states require that school children be immunized before entering school.
The results of this study suggest that physicians with patients under age 40 who have had shingles should be aware of the increased potential of vascular events. These patients should take measures to reduce other risk factors for stroke or heart attack in their lives. The use of the shingles vaccine in patients under age 60 should also be evaluated to determine if there is a benefit for young patients in light of this new data.