Helicobacter pylori infection linked to greater carotid intima-media thickness

Individuals who are positive for Helicobacter pylori infection present with greater intima-media thickening of carotid artery, according to a study, suggesting that the infection may indirectly pose an increased risk of developing major vascular events.

Researchers performed a systematic review and meta-analysis of studies to evaluate the association of H. pylori infection and carotid intima-media thickness (CIMT). They searched multiple online databases for peer‐reviewed observational studies (including cohort, cross‐sectional, and case‐control studies) which measured CIMT in adult patients who were H. pylori-positive and adult participants who were negative (controls). No other cardiovascular markers were needed for inclusion.

The initial search yielded 4,725 records, of which 13 studies were included both in the meta-analysis. These studies involved 2,298 patients, among whom 1,360 were H. pylori-positive and 938 were negative. H. pylori positivity was determined by urea breath test in 377 patients, by serum ELISA in 786, by histology in 127, and using combined methods in 70.

Pooled data showed that the overall CIMT among the infected patients was significantly larger than among uninfected control participants (weighted mean difference, 0.07 mm, 95 percent confidence interval [CI], 0.02–0.12; p=0.004; I², 91.1 percent).

The intima‐media thickening in the right common carotid artery was also significantly greater among infected patients than among controls (weighted mean difference, 0.08 mm, 95 percent CI, 0.02–0.13; p=0.007; I², 85.1 percent), but this difference was not observed for the left common carotid artery (weighted mean difference, 0.12 mm, 95 percent CI, −0.05 to 0.28; p=0.176; I², 97.4 percent).

The findings highlight the consideration of early screening and eradication of the bacteria in individuals with a thicker CIMT.