Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1995 Nov;74(5):497–501. doi: 10.1136/hrt.74.5.497

Helicobacter pylori infection: relation with cardiovascular risk factors, ischaemic heart disease, and social class.

L J Murray 1, K B Bamford 1, D P O'Reilly 1, E E McCrum 1, A E Evans 1
PMCID: PMC484068  PMID: 8562233

Abstract

OBJECTIVE--To determine whether Helicobacter pylori infection is associated with the development of ischaemic heart disease and whether such infection can explain the social class inequality in ischaemic heart disease. DESIGN--Cardiovascular risk factor levels, prevalence of ischaemic heart disease (Rose questionnaire angina, and/or a history of myocardial infarction), and serum antibodies to H pylori (enzyme linked immunosorbent assay) were assessed in a cross sectional population based survey. SETTING--Belfast and surrounding districts, Northern Ireland. PARTICIPANTS--1182 men and 1198 women aged 25-64 years randomly selected from the Central Services Agency's general practitioner lists. MAIN OUTCOME MEASURES--The relation of H pylori infection with cardiovascular risk factors and ischaemic heart disease. The association of social class with ischaemic heart disease. RESULTS--Systolic and diastolic blood pressure, plasma viscosity, and total cholesterol were not associated with H pylori infection. A weak negative association existed between H pylori infection and fibrinogen (mean (SE) difference in fibrinogen between infected and uninfected individuals -0.09 (0.04) g/l, P = 0.02) and between infection in women and high density lipoprotein (HDL) cholesterol (mean (SE) difference in HDL cholesterol between infected and uninfected individuals -0.06 (0.02) mmol/l, P = 0.006). A potentially important association was demonstrated between H pylori infection and ischaemic heart disease but this did not reach statistical significance (odds ratio (95% confidence interval (CI) 1.51 (0.93 to 2.45), P = 0.1). Social class was associated with ischaemic heart disease independently of cardiovascular risk factors and H pylori infection (odds ratio, manual v non-manual (95% CI) 1.82 (1.14 to 2.91), P = 0.01). CONCLUSION--H pylori may be independently associated with the development of ischaemic heart disease but if this is so the mechanism by which this effect is exerted is not through increased concentration of plasma fibrinogen. H pylori infection does not explain the social class inequality in ischaemic heart disease which exists independently of known cardiovascular risk factors.

Full text

PDF
497

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baker I. A., Sweetnam P. M., Yarnell J. W., Bainton D., Elwood P. C. Haemostatic and other risk factors for ischaemic heart disease and social class: evidence from the Caerphilly and Speedwell studies. Int J Epidemiol. 1988 Dec;17(4):759–765. doi: 10.1093/ije/17.4.759. [DOI] [PubMed] [Google Scholar]
  2. Chiba N., Rao B. V., Rademaker J. W., Hunt R. H. Meta-analysis of the efficacy of antibiotic therapy in eradicating Helicobacter pylori. Am J Gastroenterol. 1992 Dec;87(12):1716–1727. [PubMed] [Google Scholar]
  3. Cullen D. J., Collins B. J., Christiansen K. J., Epis J., Warren J. R., Surveyor I., Cullen K. J. When is Helicobacter pylori infection acquired? Gut. 1993 Dec;34(12):1681–1682. doi: 10.1136/gut.34.12.1681. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Evans A. E., Kerr M. M., McCrum E. E., McMaster D., McCartney L. K., Mallaghan M., Patterson C. C. Coronary risk factor prevalence in a high incidence area: results from the Belfast MONICA Project. Ulster Med J. 1989 Apr;58(1):60–68. [PMC free article] [PubMed] [Google Scholar]
  5. Fiedorek S. C., Malaty H. M., Evans D. L., Pumphrey C. L., Casteel H. B., Evans D. J., Jr, Graham D. Y. Factors influencing the epidemiology of Helicobacter pylori infection in children. Pediatrics. 1991 Sep;88(3):578–582. [PubMed] [Google Scholar]
  6. Forbes G. M., Glaser M. E., Cullen D. J., Warren J. R., Christiansen K. J., Marshall B. J., Collins B. J. Duodenal ulcer treated with Helicobacter pylori eradication: seven-year follow-up. Lancet. 1994 Jan 29;343(8892):258–260. doi: 10.1016/s0140-6736(94)91111-8. [DOI] [PubMed] [Google Scholar]
  7. Garber C. E., Carleton R. A., Heller G. V. Comparison of "Rose Questionnaire Angina" to exercise thallium scintigraphy: different findings in males and females. J Clin Epidemiol. 1992 Jul;45(7):715–720. doi: 10.1016/0895-4356(92)90048-r. [DOI] [PubMed] [Google Scholar]
  8. Graham D. Y., Malaty H. M., Evans D. G., Evans D. J., Jr, Klein P. D., Adam E. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology. 1991 Jun;100(6):1495–1501. doi: 10.1016/0016-5085(91)90644-z. [DOI] [PubMed] [Google Scholar]
  9. Lopes-Virella M. F., Stone P., Ellis S., Colwell J. A. Cholesterol determination in high-density lipoproteins separated by three different methods. Clin Chem. 1977 May;23(5):882–884. [PubMed] [Google Scholar]
  10. Markowe H. L., Marmot M. G., Shipley M. J., Bulpitt C. J., Meade T. W., Stirling Y., Vickers M. V., Semmence A. Fibrinogen: a possible link between social class and coronary heart disease. Br Med J (Clin Res Ed) 1985 Nov 9;291(6505):1312–1314. doi: 10.1136/bmj.291.6505.1312. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mendall M. A., Goggin P. M., Molineaux N., Levy J., Toosy T., Strachan D., Camm A. J., Northfield T. C. Relation of Helicobacter pylori infection and coronary heart disease. Br Heart J. 1994 May;71(5):437–439. doi: 10.1136/hrt.71.5.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Parsonnet J., Blaser M. J., Perez-Perez G. I., Hargrett-Bean N., Tauxe R. V. Symptoms and risk factors of Helicobacter pylori infection in a cohort of epidemiologists. Gastroenterology. 1992 Jan;102(1):41–46. doi: 10.1016/0016-5085(92)91782-y. [DOI] [PubMed] [Google Scholar]
  13. Patel P., Carrington D., Strachan D. P., Leatham E., Goggin P., Northfield T. C., Mendall M. A. Fibrinogen: a link between chronic infection and coronary heart disease. Lancet. 1994 Jun 25;343(8913):1634–1635. doi: 10.1016/s0140-6736(94)93084-8. [DOI] [PubMed] [Google Scholar]
  14. Pocock S. J., Shaper A. G., Cook D. G., Phillips A. N., Walker M. Social class differences in ischaemic heart disease in British men. Lancet. 1987 Jul 25;2(8552):197–201. doi: 10.1016/s0140-6736(87)90774-4. [DOI] [PubMed] [Google Scholar]
  15. ROSE G. A. The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. 1962;27:645–658. [PMC free article] [PubMed] [Google Scholar]
  16. Rose G., Marmot M. G. Social class and coronary heart disease. Br Heart J. 1981 Jan;45(1):13–19. doi: 10.1136/hrt.45.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sitas F., Forman D., Yarnell J. W., Burr M. L., Elwood P. C., Pedley S., Marks K. J. Helicobacter pylori infection rates in relation to age and social class in a population of Welsh men. Gut. 1991 Jan;32(1):25–28. doi: 10.1136/gut.32.1.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Stacey A. R., Hawtin P. R., Newell D. G. Antigenicity of fractions of Helicobacter pylori prepared by fast protein liquid chromatography and urease captured by monoclonal antibodies. Eur J Clin Microbiol Infect Dis. 1990 Oct;9(10):732–737. doi: 10.1007/BF02184685. [DOI] [PubMed] [Google Scholar]
  19. Whitaker C. J., Dubiel A. J., Galpin O. P. Social and geographical risk factors in Helicobacter pylori infection. Epidemiol Infect. 1993 Aug;111(1):63–70. doi: 10.1017/s0950268800056685. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES