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The Effects of Human Papillomavirus Infection and Vaccination on Cardiovascular Diseases. The US National Health and Nutrition Examination Survey 2003-2016

  • Author Footnotes
    # Joint authors with equal contributions
    Xiaopeng Liang
    Footnotes
    # Joint authors with equal contributions
    Affiliations
    Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
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  • Author Footnotes
    # Joint authors with equal contributions
    Oscar Hou In Chou
    Footnotes
    # Joint authors with equal contributions
    Affiliations
    Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
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  • Bernard MY Cheung
    Correspondence
    Corresponding author: Department of Medicine, School of Clinical Medicine, Queen Mary Hospital 102 Pokfulam Road Hong Kong Phone: +852 22554347 Fax: +852 28186474
    Affiliations
    Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.

    State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong, China.

    Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
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  • Author Footnotes
    # Joint authors with equal contributions
Published:October 14, 2022DOI:https://doi.org/10.1016/j.amjmed.2022.09.021

      Highlights

      • Clinical Significance:
      • There is an association between human papillomavirus (HPV) infection and cardiovascular diseases.
      • In women vaccinated against HPV, this association is not significant.
      • Our finding raises the possibility that HPV vaccination may have the additional benefit of preventing cardiovascular diseases.

      Abstract

      Background: Human papillomavirus (HPV) infection has been proposed to be an unconventional risk factor for cardiovascular diseases. We investigated the association between HPV infection and cardiovascular diseases amongst women with or without HPV vaccination.
      Methods: This cross-sectional study included 9353 women aged between 20 to 59 years old who were tested for vaginal HPV DNA in the National Health and Nutrition Examination Survey (NHANES) 2003-2016. Cardiovascular diseases were defined as the presence of self-reported coronary heart diseases, heart attacks, angina pectoris, and stroke. The association between HPV and cardiovascular diseases was studied using logistic regression, with adjustment for the potential confounders.
      Results: 40.8% of women were HPV DNA positive, and 3.0% had cardiovascular diseases. 9.0% of women received the HPV vaccine. The presence of vaginal HPV infection was associated with cardiovascular diseases [OR=1.66, 95% CI (1.28-2.16)], which remained significant [OR=1.54, (95% CI 1.15-2.08)] after adjustment for sociodemographic characteristics, lifestyle behaviors, medical history, family history of cardiovascular diseases and antihypertensive drugs. The association was absent among those who were HPV vaccinated [OR= 0.50, 95% CI (0.07-3.51)], but present among those who were not [OR=1.63, 95% CI (1.18-2.25)].
      Conclusions: There was an association between HPV infection and cardiovascular diseases. This association was not significant amongst women vaccinated against HPV. The effect of HPV vaccination on cardiovascular diseases requires further investigation.

      Keywords

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