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Ocular shingles may raise stroke risk
5 March 2010
MedWire News: People who suffer shingles involving the eye are at increased risk for suffering a stroke during the following year, say Taiwanese researchers.
Childhood infection with varicella-zoster virus (VZV), which manifests as chickenpox, is an established risk factor for childhood stroke, thought to contribute to nearly a third of childhood ischemic strokes, say Jau-Der Ho (Taipei Medical University Hospital) and colleagues.
Herpes zoster ophthalmicus (HZO), caused by reactivation of latent VZV, can be associated with severe neurologic complications. The team investigated its potential impact on stroke in 658 patients, aged 57 years on average, with HZO and 1974 age- and gender-matched controls.
In the year after HZO infection, 8.1% of patients suffered stroke, compared with 1.7% of controls, which equated to a 4.52-fold increase in stroke risk among HZO patients.
The association was independent of age, gender, and medication use. HZO patients were more likely than controls to have comorbidities including hypertension, diabetes, dyslipidemia, and heart disease, but the association with stroke remained after accounting for these conditions.
Systemic antiviral treatment was given to 155 HZO patients at the time of diagnosis, but this did not reduce their risk for suffering stroke, the researchers note in the journal Neurology.
In an accompanying editorial, Maria Nagel (University of Colorado School of Medicine, Denver, USA) and Gustavo Ortiz (University of Miami Miller School of Medicine, Florida, USA) noted that it is not known how well-controlled the patients’ blood pressure and glucose and lipid levels were.
“Perhaps patients with higher blood pressures, higher chronic blood glucose levels, and/or persistently elevated lipids are at higher risk for both HZO and stroke,” they suggested.
Nagel and Ortiz concluded: “As we face an aging population with increased risk factors for stroke, the results of this study reinforce the importance of primary and secondary stroke prevention in older people who develop HZO.”
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