Helicobacter pylori seropositivity and coronary heart disease incidence. Atherosclerosis Risk In Communities (ARIC) Study Investigators.
BACKGROUND
Several epidemiological and clinical reports have suggested seropositivity for Helicobacter pylori may be a risk factor for coronary heart disease. However, there has been no prospective study of this association involving an ethnically diverse sample of middle-aged men and women.


RESULTS
Using a prospective, case-cohort design, we determined H pylori seropositivity in relation to coronary heart disease incidence over a median follow-up period of 3.3 years among middle-aged men and women. There were 217 incident coronary heart disease cases and a cohort sample of 498. We determined H pylori antibody status by measuring IgG antibody to the high-molecular-weight cell-associated proteins of H pylori using a sensitive and specific ELISA. The prevalence of H pylori seropositivity was higher in blacks than whites, in those with less than high school education, in those with lower plasma pyridoxal 5'-phosphate and higher homocyst(e)ine concentrations, in those who did not use vitamin supplements, in those with higher fibrinogen levels, and in those seropositive for cytomegalovirus and herpes simplex type I (all P<0.05). The age-, sex-, race-, and field center-adjusted hazard ratio of coronary heart disease for H pylori seropositivity was 1.03 (95% CI=0.68 to 1.57). After adjustment for other risk factors, including fibrinogen, cytomegalovirus seropositivity, and herpes simplex type I seropositivity, the hazard ratio was 0.85 (95% CI=0.43 to 1.69). H pylori seropositivity also was not associated with increased mean intima-media thickness of the carotid artery, a measure of subclinical atherosclerosis.


CONCLUSIONS
H pylori infection is probably not an important contributor to clinical coronary heart disease events.
Folsom
A R
AR
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA. folsom@epivax.epi.umn.edu
Nieto
F J
FJ
Sorlie
P
P
Chambless
L E
LE
Graham
D Y
DY
D000907:Antibodies, Bacterial / Q000097:blood; D001161:Arteriosclerosis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000276:immunology*; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
D000907:Antibodies, Bacterial