Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China.
Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China; State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Pokfulam, Hong Kong, China; Institute of Cardiovascular Science and Medicine, University of Hong Kong, Pokfulam, Hong Kong, China.
Am J Med. 2023 Mar;136(3):294-301.e2. doi: 10.1016/j.amjmed.2022.09.021. Epub 2022 Oct 15.
BACKGROUND: Human papillomavirus (HPV) infection has been proposed to be an unconventional risk factor for cardiovascular diseases. We investigated the association between HPV infection and cardiovascular diseases among women with or without HPV vaccination. METHODS: This cross-sectional study included 9,353 women aged between 20 to 59 years old who were tested for vaginal HPV DNA in the National Health and Nutrition Examination Survey (NHANES) 2003-2016. Cardiovascular diseases were defined as the presence of self-reported coronary heart diseases, heart attacks, angina pectoris, and stroke. The association between HPV and cardiovascular diseases was studied using logistic regression, with adjustment for the potential confounders. RESULTS: A total of 40.8% of women were HPV DNA positive; 3.0% had cardiovascular diseases; and 9.0% of women received the HPV vaccine. The presence of vaginal HPV infection was associated with cardiovascular diseases (odd ratio [OR] = 1.66, 95% confidence interval [CI] 1.28-2.16), which remained significant (OR = 1.54, 95% CI 1.15-2.08) after adjustment for sociodemographic characteristics, lifestyle behaviors, medical history, family history of cardiovascular diseases, and antihypertensive drugs. The association was absent among those who were vaccinated against HPV (OR= 0.50, 95% CI 0.07-3.51) but present among those who were not (OR = 1.63, 95% CI 1.18-2.25). CONCLUSIONS: There was an association between HPV infection and cardiovascular diseases. This association was not significant among women vaccinated against HPV. The effect of HPV vaccination on cardiovascular diseases requires further investigation.
背景:人乳头瘤病毒(HPV)感染已被提出是心血管疾病的非常规危险因素。我们调查了 HPV 感染与接种或未接种 HPV 疫苗的女性心血管疾病之间的关系。
方法:本横断面研究纳入了 9353 名年龄在 20 至 59 岁之间的女性,她们在 2003 年至 2016 年的国家健康和营养调查(NHANES)中接受了阴道 HPV DNA 检测。心血管疾病定义为自我报告的冠心病、心脏病发作、心绞痛和中风的存在。使用逻辑回归研究 HPV 与心血管疾病之间的关联,并调整潜在混杂因素。
结果:共有 40.8%的女性 HPV DNA 阳性;3.0%的女性患有心血管疾病;9.0%的女性接种了 HPV 疫苗。阴道 HPV 感染与心血管疾病有关(比值比 [OR] = 1.66,95%置信区间 [CI] 1.28-2.16),调整社会人口特征、生活方式行为、病史、心血管疾病家族史和抗高血压药物后仍有显著意义(OR = 1.54,95% CI 1.15-2.08)。HPV 疫苗接种组的相关性不存在(OR = 0.50,95% CI 0.07-3.51),但未接种组的相关性存在(OR = 1.63,95% CI 1.18-2.25)。
结论:HPV 感染与心血管疾病之间存在关联。HPV 疫苗接种女性中这种关联不显著。HPV 疫苗接种对心血管疾病的影响需要进一步研究。
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