Association between Helicobacter pylori infection and arterial stiffness: Results from a large cross-sectional study

Abstract

Background: Chronic systemic inflammation is an important causative factor in the pathogenesis of atherosclerosis. However, the effect of chronic Helicobacter pylori (Hp) infection on arterial stiffness, a predictor of cardiovascular events, remains unclear. We evaluated the association between Hp infection and arterial stiffness in asymptomatic healthy individuals.

Methods: Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). We included subjects who underwent CAVI and anti-Hp IgG antibody evaluations, simultaneously, between March 2013 and July 2017. Demographic characteristics and metabolic and cardiovascular parameters were compared with respect to anti-Hp IgG antibody status. Multivariable logistic regression analyses were performed to determine the effect of Hp-seropositivity and conventional cardiovascular risk factors on arterial stiffness.

Results: Of 2,251 subjects, 1,326 (58.9%) were included in the Hp-seropositive group. Median age (P < 0.001) and systolic blood pressure (P = 0.027) were significantly higher in the Hp-seropositive than in the Hp-seronegative group. Levels of LDL-cholesterol were significantly higher in the Hp-seropositive than in the Hp-seronegative group (P = 0.016). Other serum metabolic parameters were not significantly different between the two groups. The median CAVI value and the proportion of subjects with a CAVI ≥ 8 were significantly higher in the Hp-seropositive than in the Hp-seronegative group (both P < 0.001). On multivariable logistic regression analyses, Hp-seropositivity, age, body mass index, waist circumference, smoking, hypertension, diabetes mellitus, and dyslipidemia were significantly associated with high CAVI values. In the subgroup analysis conducted according to age group, a tendency towards an increased association between Hp-seropositivity and CAVI was observed with increasing age, even though the difference did not reach the statistical significance.

Conclusions: Hp-seropositivity was significantly associated with arterial stiffness. Hp infection may contribute to the development of cardiovascular diseases.

Fig 1. Study population.

CAVI, cardio-ankle vascular index; H. pylori, Helicobacter pylori; n, number; IHD, ischemic heart disease; PAD, peripheral artery disease.

Fig 2. Subgroup analysis of the effect of Hp-seropositivity on CAVI levels by age group.

When multivariable analysis was performed with variables affecting CAVI, the effect of Hp-seropositivity on CAVI levels increased with age. However, we did not find any significant interaction between age and Hp infection on arterial stiffness through a test of interaction. Hp, Helicobacter pylori; CAVI, cardio-ankle vascular index; n, number; OR, odds ratio; CI, confidence interval.