Risk of Stroke and Myocardial Infarction After Herpes Zoster in Older Adults in a US Community Population

Objective: To assess the risk of stroke and myocardial infarction (MI) after herpes zoster in a US community population of older adults. Patients and Methods: We performed a community cohort study (January 1, 1986, to October 1, 2011) comparing the risk of stroke and MI in 4862 adult residents of Olmsted County, Minnesota, 50 years and older with and without herpes zoster and 19,433 sex-and age-matched individuals with no history of herpes zoster. Odds ratios are presented for MI and stroke at 3, 6, 12, and 36 months after index herpes zoster plus hazard ratios for long-term risk (up to 28.6 years). Results: Individuals with herpes zoster had more risk or confounding factors for MI and stroke, suggesting that they had worse health status overall. When controlling for the multiple risk factors, those with herpes zoster were at increased risk for stroke at 3 months after herpes zoster compared with those without a history of herpes zoster (odds ratio, 1.53; 95% CI, 1.10-2.33; P = .04). The association between herpes zoster and MI at 3 months was not robust across analytic methods. Herpes zoster was not associated with an increased risk of stroke or MI at any point beyond 3 months. Conclusions: Herpes zoster was associated with only a short-term increased risk of stroke, which may be preventable with the prevention of herpes zoster. (C) 2016 Mayo Foundation for Medical Education and Research