title: Helicobacter pylori infection and mortality from ischaemic heart disease: negative result from a large, prospective study.
abstract: OBJECTIVE
  To determine whether there is an independent association between Helicobacter pylori infection of the stomach and ischaemic heart disease.
  
  
  METHODS
  Prospective study with measurement of IgG antibody titres specific to H pylori on stored serum samples from 648 men who died from ischaemic heart disease and 1296 age matched controls who did not (nested case-control design).
  
  
  METHODS
  21,520 professional men aged 35-64 who attended the British United Provident Association (BUPA) medical centre in London between 1975 and 1982 for routine medical examination.
  
  
  METHODS
  Death from ischaemic heart disease.
  
  
  RESULTS
  The odds of death from ischaemic heart disease in men with H pylori infection relative to that in men without infection was 1.06 (95% confidence interval 0.86 to 1.31). In a separate group of 206 people attending the centre, plasma fibrinogen was virtually the same in those who were positive for H pylori (2.62 g/l) and those who were negative (2.64 g/l).
  
  
  CONCLUSIONS
  A study that by its size and design minimised both random error and socioeconomic bias found no relation between H pylori infection and ischaemic heart disease. The validity of the study was shown by its confirmation of the recognised association between H pylori infection and stomach cancer (odds ratio 4.0 (1.9 to 8.2); P < 0.001). Eradication of H pylori infection may greatly reduce the incidence of stomach cancer, one of the most common causes of death from cancer worldwide, but it cannot be expected to have any effect in preventing ischaemic heart disease.
authors.affiliation: Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St Bartholomew's, London. nj.wald@mds.qmw.ac.uk
authors.forename: N J
authors.initials: NJ
authors.lastname: Wald
authors.forename: M R
authors.initials: MR
authors.lastname: Law
authors.forename: J K
authors.initials: JK
authors.lastname: Morris
authors.forename: A M
authors.initials: AM
authors.lastname: Bagnall
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016481:Helicobacter Infections / Q000150:complications* / Q000401:mortality; D016480:Helicobacter pylori; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000382:microbiology / Q000401:mortality*; D015995:Prevalence; D011446:Prospective Studies