Shingles Seemed to Increase Stroke Risk

Chicken pox virus made individuals prone to stroke but antivirals may help

(RxWiki News) People who had chicken pox as a child may develop shingles — an often painful, blistering rash caused by the same virus — as an adult. Now researchers suggest that having shingles may lead to a more serious health issue.

People with shingles may have an increased risk for stroke, new research suggests. This stroke risk may be even higher if the virus activates in the nerve around the eyes, the researchers found.

"If you are 60 years or older, ask your doctor about the vaccine to prevent shingles."

This research was led by Sinéad Langan, MD, PhD, of the London School of Hygiene and Tropical Medicine in the United Kingdom. The researchers used data from the UK Clinical Practice Research Datalink from 1987-2012. The study included 6,584 individuals 18 years of age and older who experienced shingles for the first time and also had their first stroke.

The herpes zoster virus is the virus that causes chicken pox. It stays dormant in the body for years and sometimes reactivates as shingles. Shingles can be treated with antivirals. Antivirals decrease the risk for stroke in these patients, the study authors noted. Such medications had been given to about 55 percent of those who had shingles in this study.

The researchers found that the risk for stroke was particularly high in the first six months following the onset of shingles. The risk was highest in the first month when the rate of stroke was 63 percent higher for the person than it was when that person did not have shingles, the researchers found. Risk gradually declined over six months.

The risk for stroke was three times as high if the person had zoster ophthalmicus, which is when the virus erupts around the eye.

If the virus settled in the trigeminal nerve, which is a nerve responsible for sensation in the face, the risk was also higher than otherwise. 

In this study, 6 percent of people had zoster ophthalmicus, and only half a percent had zoster in other branches of the trigeminal nerve.

The study's authors suggested various ways zoster may increase risk for stroke, such as that the virus causes inflammation throughout the body, and it could also invade arterial walls, causing disease of the blood vessels.

There is a vaccine available to prevent shingles, the authors added. It is available in the United States for people 60 and older.

This study was published April 2 in Clinical Infectious Diseases.

In the same journal, Maria Nagel, MD, and Don Gilden, MD, of the University of Colorado School of Medicine wrote, “Overall, while varicella after primary VZV [varicella zoster virus] infection is typically benign, disease after VZV reactivation is often serious, with zoster emerging as an important risk factor for stroke, TIA [transient ischemic attack; known as a mini stroke because its effects are very short], and MI [myocardial infarction or heart attack].”  This may lead to change, they added. “The growing awareness of the role of VZV in vascular disease promises to lead to clinical trials to assess the benefit of antiviral therapy.”

The authors of the study disclosed no conflicts of interest.

Review Date: 
April 7, 2014