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Your Guide To Adult Vaccines

Shingles May Increase Risk of Heart Disease

Study suggests long-term risk of cardiovascular event after shingles outbreak

doctor administering shingles vaccine


En español

If you’ve ever had chicken pox — and you probably have — you are at risk for shingles later in life. An outbreak of shingles can be deeply painful, but that may not be the worst of it. A new study suggests shingles may put you at greater risk of a stroke or heart attack than researchers had previously thought.

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The study, published in the Journal of the American Heart Association, found that adults who had shingles (also known as herpes zoster):

  • Had an almost 30 percent higher long-term risk of a major cardiovascular event
  • The elevated risk may persist for 12 years or longer
  • The risk could be greater for adults whose immune system may be weakened by disease or medication

“Our findings suggest there are long-term implications of shingles, and highlight the importance of public health efforts for prevention,” lead author Sharon Curhan, M.D., an epidemiologist at Brigham and Women’s Hospital in Boston, said in a statement.

More than 200,000 study participants

The varicella zoster virus, which causes chicken pox and shingles, has been detected in large and small blood vessels, and over time that can cause inflammation as well as chronic vascular changes that could be harmful. The researchers noted that a growing body of evidence had made this connection — including 15 recent epidemiological studies from Asia, Europe and the U.S. — but there wasn’t much data on long-term risk, and the findings from the data that was available were inconsistent. Curhan and her fellow researchers used data collected through three long-term studies — the Nurses’ Health Study, the Nurses’ Health Study II and the Health Professionals Follow-Up Study — to address the shortfall.

The researchers followed more than 200,000 participants from these studies, who began with no prior history of stroke or coronary heart disease, for up to 16 years. Information on shingles, stroke and coronary heart disease was collected using questionnaires that participants filled out every two years. The researchers also reviewed medical records to confirm any diagnosis.

The researchers found that those receiving the shingles vaccine had an 18 percent lower risk of ischemic (clot-caused) stroke and a 12 percent lower risk of hemorrhagic (bleeding) stroke. The vaccine’s protection was strongest among people ages 66 to 79.

After analyzing the results, they determined that a history of shingles was associated with a higher long-term risk of suffering a major cardiovascular event.

Get vaccinated

It wasn’t until 2006 that the Food and Drug Administration approved a vaccine against shingles. The Centers for Disease Control and Prevention (CDC) now recommends the recombinant shingles vaccine for people age 50 and older.

Curhan notes that most of the data used in her study was collected before the shingles vaccine was available, so they were not able to evaluate whether vaccination status influences the association of shingles and long-term risk of a major cardiovascular event. They intend to conduct additional studies that would address this data shortfall.

Regardless, she suggests that older adults get the shingles vaccine.

“Given the growing number of Americans at risk for this painful and often disabling disease and the availability of an effective vaccine, shingles vaccination could provide a valuable opportunity to reduce the burden of shingles and reduce the risk of subsequent cardiovascular complications,” Curhan said.

Meanwhile, preliminary research from a 2020 study suggests the shingles vaccine may lower the risk of stroke for some adults, particularly those ages 66 to 79, as AARP reported.

“Our study results may encourage people ages 50 and older to follow the recommendation and get vaccinated against shingles. You are reducing the risk of shingles, and at the same time you may be reducing your risk of stroke,” study lead author Quanhe Yang, a senior scientist at the CDC in Atlanta, said when the study results were presented in 2020 at the American Stroke Association’s International Stroke Conference in Los Angeles.

Yang and his colleagues reviewed the Medicare health records of more than a million Medicare fee-for-service beneficiaries age 66 or older who had no history of stroke and who were vaccinated with the zoster vaccine between 2008 and 2014, and followed them for an average of almost four years. That group was matched with an equal number of Medicare fee-for-service beneficiaries who did not receive the shingles vaccine, with the same four-year follow-up.