Helicobacter Pylori Infection and Risk of Death From Cardiovascular Disease Among the Japanese Population: a Nested Case-Control Study within the JACC Study

Aim: An increasing number of studies have linked Helicobacter pylori (H. pylori) infection to extragastric diseases; however, the role of H. pylori in the pathogenesis of cardiovascular disease (CVD) remains controversial. We examined the association between H. pylori infection and risk of death from coronary heart disease (CHD) and stroke in a nested case-control study within a large prospective cohort study of Japanese subjects. Methods: The cases were 627 subjects who died from CHD and stroke during the follow-up period until December 31, 2003, and 627 control subjects were selected and matched to cases on sex, age, and area. Commercial immunoassay IgG enzyme-linked immunosorbent assay kits were used for the determination of the seropositivity for H. pylori. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using a conditional logistic regression model. Results: Overall, H. pylori infection was not associated with CVD (CHD and stroke) mortality risk. The multivariable OR was 0.96 (0.76-1.21) for the H. pylori positive subjects in comparison with H. pylori negative subjects. As for the subtype of CVD, H. pylori appears to be inversely associated with the risk of death from CHD, with an OR of 0.79 (0.50-1.25), but this was not statistically significant. No significant association was observed between H. pylori infection and stroke, with an OR of 1.02 (0.78-1.33). Conclusion: The results of this nested case-control study suggest that there is no association between H. pylori infection and CHD and stroke mortality risk in otherwise healthy, elderly Japanese individuals.