Growing body of evidence links HPV with heart disease

Evidence that HPV is linked with heart disease has begun to emerge only recently. This new study is the first to assess the association by pooling data from several global studies, totaling nearly 250,000 patients. Its findings bolster the evidence that a significant relationship exists and warrants further attention from researchers, clinicians and patients.

"Our study shows that clearly there is an association of some kind between HPV and cardiovascular disease," said Stephen Akinfenwa, MD, an internal medicine resident at UConn School of Medicine in Farmington, Connecticut, and the study's lead author. "The biological mechanism has not been determined but is hypothesized to be related to chronic inflammation. We would ultimately like to see if reducing HPV via vaccination could reduce cardiovascular risk."

HPV is a common viral infection spread by intimate contact. It can cause genital warts and cancers of the genitals, anus and throat. The U.S. Centers for Disease Control and Prevention recommends that all children and teens receive the HPV vaccine to prevent cancers associated with the infection; however, many U.S. adults have not been vaccinated because they were past the recommended age to receive the vaccine when it became available in 2006.

For the meta-analysis, researchers identified seven studies conducted between 2011 and 2024 that included data on HPV status and cardiovascular outcomes across a follow-up time of three years to 17 years. Most were retrospective and longitudinal cohort studies; three were from the United States, two were from South Korea, one was from Brazil and one was from Australia.

The researchers used several statistical approaches to extract data on the relationship between HPV and cardiovascular disease, coronary artery disease (a condition when plaque builds up in the heart's arteries, reducing blood flow to the heart) and high blood pressure among the pooled study cohorts. Some of the analyses also adjusted for potential confounding variables such as smoking, diabetes and other known heart disease risk factors.

Overall, the results showed that HPV-positive patients had a 40% higher likelihood of developing cardiovascular disease and twice the risk of developing coronary artery disease compared with HPV-negative patients. Even after adjusting for confounding variables such as sociodemographic factors, medical history, lifestyle behaviors, family history of heart disease and use of blood pressure-lowering drugs, the relationship between HPV and heart disease remained, with HPV-positive patients having a 33% higher risk of developing cardiovascular disease compared with patients without HPV. No statistically significant association was found with high blood pressure.

Based on the findings, Akinfenwa said that clinicians could consider closer heart monitoring for people who test positive for HPV, in keeping with recommendations for patients with other known heart disease risk factors.

"We always talk about cardiovascular risk factors like smoking, high blood pressure and so on, but we know that about 20% of cardiovascular disease cannot be explained by these conventional risk factors," Akinfenwa said. "This makes it important to identify non-conventional risk factors like HPV that could potentially be targeted."

He said that further research is needed to better understand the strength and mechanisms of the linkage between HPV infection and heart disease and the potential role of HPV vaccination in preventing cardiovascular problems.