January 2012
Women with HPV may have
a higher risk of heart disease
A recent study of nearly 2,500 women between the ages of 20 and 59 shows that women who carry the human papillomavirus (HPV) have an increased risk of heart disease and are twice as likely to have had a heart attack or stroke. Nearly 20 percent of people who develop heart disease do not have any known risk factors, such as smoking or high blood pressure, which indicates that other "nontraditional" causes may be involved. HPV appears to be one such factor among women. The link might be due to the virus's ability to silence two genes known to play roles in the health of blood vessels.
What the news means to you
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Most people infected with HPV are unaware of it and do not have symptoms.
Suman
Tandon, MD
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HPV is the most common sexually transmitted disease in the United States, infecting the genital areas, mouth and throat of men and women. Most people infected with HPV are unaware of it and do not have symptoms. Approximately 90 percent of patients clear the infection naturally. If a woman has been diagnosed with HPV and has conventional cardiovascular risk factors, the focus should be on the management and reduction of these risk factors as there is no treatment for the virus itself. Maintaining a healthy weight, abstaining from smoking, optimizing blood pressure control, reducing LDL (bad cholesterol), improving HDL (good cholesterol) and improving blood glucose control are the mainstay of prevention. Women with HPV without traditional cardiovascular risk factors should be aware of but not worried about this new association. They should seek prompt evaluation if they have symptoms such as chest pain rather than ignoring it.
Although we have come a long way in our current understanding of the atherosclerotic process, there are still a significant number of cases where the underlying cause is unclear and the evaluation of nontraditional risk factors is neccessary. HPV can inactivate two genes in the body, p53 and the retinoblastoma gene. Both of these genes are responsible for suppressing the growth of tumors and play a role in the health of blood vessels. The suppression of these genes by HPV provides an explanation for the link between HPV and cardiovascular disease.
Although a causal relationship between HPV and heart disease has not been definitively established, women should take adequate precautions to prevent HPV infection with its potential risk of cancer. In addition to practicing safe sexual behaviors, they should obtain HPV vaccination as young women, and undergo routine pap smear for cervical cancer screening. There are two vaccines for use in the United States providing protection against cervical cancer as well as genital warts. The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend HPV vaccination of females at age 11 or 12. If not previously vaccinated, young women up to the age of 26 should be vaccinated.
Suman Tandon, MD, is an attending physician at Yale-New Haven Hospital and an instructor in internal medicine at Yale School of Medicine.