Risk factors for coronary heart disease and infection with Helicobacter pylori: meta-analysis of 18 studies

BMJ 1998;316:1130-1132 ( 11 April )

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Risk factors for coronary heart disease and infection with Helicobacter pylori: meta-analysis of 18 studies

John Danesh, Rhodes scholar, Richard Peto, professor of medical statistics and epidemiology.

Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE

Correspondence to: Dr Danesh john.danesh{at}balliol.ox.ac.uk

Objective: To find out if chronic infection with Helicobacter pylori is correlated with risk factors for coronary heartdisease.
Design: Meta-analysis of 18 epidemiological studies, involving a total of 10 000 patients, that measured serum antibodytitres to H pylori and risk factors for coronary heart disease.Any study published in any language before 1998 was eligible forinclusion.
Results: Only small absolute differences in body mass index, blood pressure, or haematological risk factors were foundbetween subjects who were seropositive and those who were seronegative.In those who were seropositive body mass index was slightly higher(0.37, SE 0.09) and concentrations of high density lipoproteincholesterol were slightly lower (0.032 mmol/l, 0.008). None ofthe other differences were highly significant.
Conclusion: Previous claims of substantial correlations between H pylori seropositivity and certain vascular risk factorswere largely or wholly due to chance or the preferential publicationof positive results, or both.

Key messages

Epidemiological studies suggest that there is a weakly positive association between coronary heart disease and chronic infection with Helicobacter pylori
A number of reports have also claimed that there are strong correlations between infection with H pylori and an increase in vascular risk factors, such as plasma fibrinogen concentrations
Meta-analysis of 18 studies that involved 10 000 people found no strong correlations between H pylori seropositivity and vascular risk factors; previous findings of the existence of such correlations in small studies were largely or wholly due to chance or to the preferential publication of positive results

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