Herpes Zoster and Cardiovascular Disease: Exploring Associations and Preventive Measures through Vaccination

Abstract

Herpes zoster, induced by the reactivation of the varicella-zoster virus (VZV), is a unilaterally distributed vesicular rash that can cause multiple complications. VZV not only causes neurological problems, including postherpetic neuralgia and ocular zoster, but also causes inflammatory vasculopathy and increases the incidence of hemorrhagic or ischemic complications. Therefore, understanding the association between the development of herpes zoster and the subsequent occurrence of acute stroke or cardiovascular diseases, including myocardial infarction and heart failure, is of great interest. Conversely, many risk factors are involved in the development of herpes zoster. Recently, it has become clear that aging, insufficient immune function, and diseases related to lifestyle habits (for example, stroke and cardiovascular disease), can trigger the onset of herpes zoster. Preventing the onset of herpes zoster, which substantially reduces quality of life, will lead to lower medical costs for countries and extend healthy life expectancy for general populations. Thus, because herpes zoster is a vaccine-preventable disease, active vaccination is recommended for high-risk groups. This review summarizes the association between herpes zoster and cardiovascular disease and vaccination against herpes zoster as a useful disease management and prevention measure for cardiovascular disease.

Keywords: antiviral treatment; inflammation; stroke; vaccines; vasculopathy.

Figure 1

A flowchart depicting the selection process. A total of 25 studies were imported for title and abstract screening after removing duplicates or determining ineligibility. Following a comprehensive full-text review, 16 studies were deemed eligible, and 9 reports were ultimately included in the review.

Figure 2

Relationship between cardiovascular disease and herpes zoster. Cardiovascular diseases, including myocardial infarction, heart failure, and stroke, are closely related to the onset and worsening of herpes zoster. Furthermore, severe complications induced by herpes zoster are important for cardiovascular diseases, such as vasculopathy, myocarditis, arrhythmia, and sudden death. Aggressive vaccination against the varicella-zoster virus is essential for the prevention and management of cardiovascular diseases. COPD, chronic obstructive pulmonary disease; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; BS, Behçet’s syndrome; AIDS, acquired immunodeficiency syndrome; VZV, varicella zoster virus; CKD, chronic kidney disease; UVR, ultraviolet radiation.