title: Association of Helicobacter pylori and Chlamydia pneumoniae infections with coronary heart disease and cardiovascular risk factors.
abstract: OBJECTIVE
  To investigate the relation between seropositivity to chronic infections with Helicobacter pylori and Chlamydia pneumoniae and both coronary heart disease and cardiovascular risk factors.
  
  
  METHODS
  Cross sectional study of a population based random sample of men. Coronary heart disease was assessed by electrocardiography, Rose angina questionnaire, and a history of myocardial infarction; serum antibody levels to H pylori and C pneumoniae were measured, risk factor levels determined, and a questionnaire administered.
  
  
  METHODS
  General practices in Merton, Sutton, and Wandsworth, south London.
  
  
  METHODS
  388 white south London men aged 50-69.
  
  
  METHODS
  Evidence of coronary risk factors and infection with H pylori or C pneumoniae.
  
  
  RESULTS
  47 men (12.1%) had electrocardiographic evidence of ischaemia or infarction. 36 (76.6%) and 18 (38.3%) were seropositive for H pylori and C pneumoniae, respectively, compared with 155 (45.5%) and 62 (18.2%) men with normal electrocardiograms. Odds ratios for abnormal electrocardiograms were 3.82 (95% confidence interval 1.60 to 9.10) and 3.06 (1.33 to 7.01) in men seropositive for H pylori and C pneumoniae, respectively, after adjustment for a range of socioeconomic indicators and risk factors for coronary heart disease. Cardiovascular risk factors that were independently associated with seropositivity to H pylori included fibrinogen concentration and total leucocyte count. Seropositivity to C pneumoniae was independently associated with raised fibrinogen and malondialdehyde concentrations.
  
  
  CONCLUSIONS
  Both H pylori and C pneumoniae infectins are associated with coronary heart disease. These relations are not explained by a wide range of confounding factors. Possible mechanisms include an increase in risk factor levels due to a low grade chronic inflammatory response.
authors.affiliation: St George's Hospital Medical School, Tooting, London.
authors.forename: P
authors.initials: P
authors.lastname: Patel
authors.forename: M A
authors.initials: MA
authors.lastname: Mendall
authors.forename: D
authors.initials: D
authors.lastname: Carrington
authors.forename: D P
authors.initials: DP
authors.lastname: Strachan
authors.forename: E
authors.initials: E
authors.lastname: Leatham
authors.forename: N
authors.initials: N
authors.lastname: Molineaux
authors.forename: J
authors.initials: J
authors.lastname: Levy
authors.forename: C
authors.initials: C
authors.lastname: Blakeston
authors.forename: C A
authors.initials: CA
authors.lastname: Seymour
authors.forename: A J
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D002690:Chlamydia Infections / Q000097:blood / Q000150:complications*; D016993:Chlamydophila pneumoniae; D003327:Coronary Disease / Q000097:blood / Q000382:microbiology*; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005340:Fibrinogen / Q000032:analysis; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D007958:Leukocyte Count; D008131:London; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein