Shingles, also known as herpes zoster, is a viral infection characterized by a painful rash. This condition arises from the reactivation of the varicella-zoster virus (VZV), which is the same virus responsible for causing chickenpox. After an initial chickenpox infection, VZV remains dormant within the body’s nervous system. Years later, the virus can reactivate, leading to shingles, which typically manifests as a stripe of fluid-filled blisters that can appear on one side of the body or face.
Understanding the Link
Research indicates a potential connection between shingles and an elevated risk of certain cardiovascular events. While shingles is primarily recognized for its characteristic painful rash, the varicella-zoster virus can exert systemic effects. Studies have shown that individuals who have experienced shingles face an increased likelihood of developing heart-related issues. A 2022 study found that people with a history of shingles had a nearly 30% increased risk of experiencing a future cardiovascular event, including stroke (up to 38% higher) and coronary heart disease (up to 25% higher). This association can persist for 12 years or more after the initial shingles episode.
Mechanisms of Cardiac Impact
The varicella-zoster virus can influence cardiovascular health through several pathways. One mechanism involves widespread inflammation triggered by the viral infection. This systemic inflammation can damage blood vessels throughout the body and contribute to the instability of arterial plaques. Such inflammatory responses are recognized as factors in the development and progression of various cardiovascular diseases.
The virus can also directly affect blood vessels, a process known as vasculopathy. VZV has been shown to replicate in arteries, potentially leading to damage or narrowing of these vessels, including those supplying the heart and brain. This direct viral action on the vascular system can compromise blood flow and increase the risk of adverse cardiovascular events.
While less common, the virus can directly affect heart tissue. VZV can lead to conditions such as myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the sac surrounding the heart). However, the more prevalent pathways for cardiac impact after shingles involve broader systemic inflammation and direct damage to blood vessels.
Identifying Risk Factors
Several factors can increase an individual’s risk of developing heart problems after a shingles infection. Age plays a significant role, with older adults, particularly those over 50, facing a higher risk both for shingles itself and for subsequent cardiovascular complications. The immune system naturally weakens with age, making it more susceptible to viral reactivation and its systemic consequences.
The severity of the shingles infection can also influence the risk. Severe cases, or those affecting specific areas like the head or face (herpes zoster ophthalmicus), might be associated with a higher risk of complications. Individuals with pre-existing cardiovascular conditions, such as high blood pressure, high cholesterol, or diabetes, are also more vulnerable. A weakened immune system due to other diseases or medications can further elevate the risk of developing these complications after a shingles episode.
Protective Measures
There are actionable steps individuals can take to reduce the risk of heart problems following a shingles infection. Vaccination against shingles is considered the primary and most effective preventive measure. The recombinant zoster vaccine, Shingrix, is highly effective, offering more than 90% protection against shingles in adults over 50. Studies show that receiving the shingles vaccine can lower the risk of cardiovascular events, including stroke, heart failure, and coronary heart disease, by as much as 23% overall, with a 26% lower risk for major cardiovascular events. This protective effect can last for up to eight years after vaccination.
Seeking prompt medical attention for shingles and initiating antiviral medication is also important. Antiviral drugs, when administered early in the course of the infection, can help reduce the severity and duration of the rash and may lower the risk of complications, including cardiovascular events. One study found that antiviral treatment was associated with a lower risk of cardiovascular events after a shingles diagnosis.
Maintaining overall cardiovascular health through lifestyle choices also supports protection. Engaging in regular exercise, adopting a balanced and healthy diet, and effectively managing pre-existing chronic conditions like high blood pressure or diabetes can contribute to a stronger immune system and better cardiovascular resilience. These general health practices complement the specific preventive measures against shingles and its potential cardiac effects.