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Shingles linked to stroke, heart attack

Common virus may increase risk of cardiovascular event


Shingles flare-ups hurt, but now new research finds that they can also increase your short-term risk of heart attack and stroke following the virus’ outbreak.

Examining the records of more than 67,000 seniors on Medicare, researchers found that that patients newly diagnosed with shingles more than doubled their risk for stroke and nearly doubled their risk for heart attack in the month following an episode. The risk for both returned to normal after 6 months, according to the study.

“It’s been known for a while now that zoster causes stroke,” said Dr. Gwen Wigand-Bolling, an internist at Novant Health Forsyth Internal Medicine. “The inflammation causes heart attack and stroke and shingles causes increased blood clotting in the arteries,” the doctor added.

Almost one-third of all Americans will develop shingles in their lifetime, according to the Centers for Disease Control and Prevention. About half of all cases are in people 60 or older.

“Seniors are most vulnerable,” Bolling said, “because as we age we lose immunity to zoster.”

Shingles, also known as zoster or herpes zoster, affects approximately 1 million people each year. The condition is common because anyone who has had chickenpox has been exposed to the virus that causes shingles.

Once a person recovers from chickenpox, the virus will lie dormant in that individual until some unknown trigger causes the virus to reactivate. However, not everyone who had chickenpox during childhood will develop shingles later in life, according to the National Institute of Neurological Disorders and Stroke.

Shingles presents itself as a painful rash or blisters but the first signs of the condition can appear as a burning or tingling pain or itch on only one side of the body. Usually, shingles will appear around the waist, chest, stomach, back or on the face. Some people may experience symptoms associated with a general infection such as fatigue, fever and headache.

“Shingles is extremely painful, said Bolling. “On a scale from one to 10, most patients will say the pain ranges from six to 10.”

Between one and five days after the first symptoms occur, a rash will develop in the affected area. The rash will form blisters similar to chickenpox, but clustered in one area of body rather than scattered all over. The blisters generally scab over within seven to 10 days and the rash clearing in two to four weeks, according to the CDC.

There is no cure for shingles, but attacks can be rendered less severe and their duration shortened with the use of prescription antiviral drugs. Doctors recommend starting antiviral drugs at the first sign of the shingles rash. In addition, the NIH reports that use of antiviral drugs can reduce by about half the chronic pain that sometimes last months after the shingles has cleared.

“Taking antivirals such as a Valacyclovir or Famciclovir will reduce the duration of the shingles and the severity of the neuralgia,” said Bolling. “Shingles generally lasts about three weeks, but the neuralgia can last much longer."

“Once a person has shingles, there is a 1 to 4 percent chance that individual would have a second occurrence of shingles,” Bolling said.

Prevention is the best way to avoid a shingles episode.

There is a vaccine that prevents the onset of shingles in people exposed to chickenpox. The CDC recommends that people age 60 and older get one dose of the vaccine. Vaccines are readily available at a doctor’s office and drug stores. In 2011, the Food and Drug Administration extended the vaccine use for people aged 50 to 59.

Bolling said the vaccine reduces the incidence of shingles by 51 percent and the neuralgia associated with shingles by 67 percent. The doctor said the vaccine is injected and once vaccinated a person is protected for life.

“Unless contraindicated because of pregnancy or being an organ transplant recipient or on chemotherapy, everyone over age 50 should be vaccinated,” Bolling said. “I would recommend getting vaccinated to patients who may not have had chicken pox, or those who don’t remember having chicken pox.”

More than 90 percent of those identified in the study at increased risk of stroke and heart attack after a shingles episode hadn't been vaccinated for shingles. The people in the study who had the vaccine still got shingles.

The researchers were not entirely clear on what triggered the increased risk of heart attack and stroke in people with shingles, but they suggested that inflammation may lead to blood clots in individuals with hardening of the arteries. Also, the stress associated with the pain from shingles might have contributed to the effect.





Published: 2/25/2016