The Connection Between Shingles, Stroke and Heart Attack

By MaryAnn DePietro, CRT. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Shingles, also known as herpes zoster, is a virus that can cause painful, unsightly skin rashes. While doctors have known shingles can lead to serious complications, a new study in Neurology journal suggests sufferers may have an increased risk of a heart attack or stroke.

Researchers from the American Academy of Neurology in the United Kingdom studied more than 100,000 people with singles and found that those who developed shingles before the age of 40 appeared to be at greater risk for stroke, mini stroke and heart attack compared with those who had never had shingles.

“This is an interesting study that suggests an association between herpes zoster infections and stroke or heart attack,” says Ralph L. Sacco, MD, MS, chairman of neurology at the Jackson Memorial Hospital and Miller School of Medicine at the University of Miami. “We are increasingly finding relationships between common chronic infections and stroke risk, which, in the future, may offer new hints about ways to prevent stroke.”

How Shingles is Linked to Heart Attack and Stroke

Shingles is caused by the same virus that causes chickenpox — the varicella-zoster virus — and anyone who has ever had chickenpox is at risk of developing shingles, usually later in life.

Understanding how shingles plays a role in strokes and heart attacks is the first step in learning ways to reduce these life-threatening events. According to the National Vaccine Information Center, shingles causes inflammation of the nerves, which leads to a painful rash, fever and headache.

But if shingles affects the nerves and skin, how does that lead to an increased risk of heart attack and stroke? Inflammation caused by shingles is a possible explanation.

“The inflammation associated with the varicella zoster (chickenpox) virus may travel to certain blood vessels, which damages the vessel and alters blood flow to the brain or heart,” says Marc I. Leavey, MD, a Baltimore primary care internist who has treated many shingles patients.  

It is generally believed that inflammation plays a major role in cardiovascular disease and cerebrovascular disease, or stroke. “The localized nature of some zoster infections, particularly those involving nerves associated with the face or eye, may be a direct path for that inflammation to travel to the brain leading to stroke or [mini stroke],” Leavey adds.

It appears that people who had shingles before the age of 40 were at a greater risk of stroke or heart attack than those who developed it after, but additional research is needed. “Many younger patients who develop shingles may also have co-morbidities, including connective tissue disorders, diabetes, asthma, or other disorders that cause increased risk for vascular events,” says Leavey.

Next Steps

Knowing there may be an association between shingles, inflammation and heart attack is helpful because you can take steps to enhance your health and lose bad habits:

  • Assess your additional risk factors. Speak with your doctor about what other risk factors you may have for heart attack or stroke. Depending on your risk, your doctor may recommend certain medications or lifestyle tweaks.
  • Reduce controllable risks. Certain risk factors, such as gender, and age cannot be controlled. However, other risk factors, such as smoking, obesity and a sedentary lifestyle, can be changed.   
  • Get the shingles vaccine. The Centers for Disease Control and Prevention recommends all adults 60 and older get the vaccine, so speak with a healthcare provider today.

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