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Espinosa-Tamez P, Lajous M, Cantú-Brito C, Lopez-Ridaura R, Monge A, Yunes E, Rodríguez BL, Espinosa L, Sifuentes-Osornio J, Catzin-Kuhlmann A. Association of recurrent common infections and subclinical cardiovascular disease in Mexican women. PLoS One 2021; 16:e0246047. [PMID: 33497395 PMCID: PMC7837493 DOI: 10.1371/journal.pone.0246047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute and agent-specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections on cardiovascular disease is limited. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD). METHODS In a cross-sectional study, we assessed the relation of recurrent infections and carotid artery intima-media thickness (IMT) in 1946 disease-free women from the Mexican Teachers' Cohort. Through 2012-2016, participants answered structured questions on respiratory, urinary and vaginal infections during the previous year and their IMT was measured using ultrasound by standardized neurologists. We defined sCVD as mean right and left IMT ≥0.8 mm or the presence of atheromatous plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting for age, sociodemographic, and cardiovascular risk factors. RESULTS Among participants (50±5 years) 13% reported no infections, 20% one infection and 67% three or more episodes. Overall prevalence of sCVD was 12%(n = 240). Adjusted models for logistic regression showed that women with 2 or more infections had 91% higher odds of sCVD (OR 1.91; 95%CI 1.16, 3.13) compared to women without infections (p-trend:0.015). Sub-analyses by type of infection resulted not significant. Linear regression analysis did not show a significant association between mean IMT and recurrent infections. CONCLUSIONS Recurrent infectious events in young adult women are associated with greater sCVD, which supports the hypothesis of low-grade chronic inflammation in the pathophysiology of cardiovascular disease.
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Affiliation(s)
- Priscilla Espinosa-Tamez
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
| | - Martin Lajous
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Carlos Cantú-Brito
- Division of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, Mexico
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - Ruy Lopez-Ridaura
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
| | - Adriana Monge
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - Elsa Yunes
- Center for Population Health Research, National Institute of Public Health, Tlalpan, Mexico City, Mexico
| | - Beatriz L. Rodríguez
- Department of Geriatric Medicine, University of Hawaii, Honolulu, HI, United States of America
| | - Luis Espinosa
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - José Sifuentes-Osornio
- Department of Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, Mexico
| | - Andres Catzin-Kuhlmann
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
- Department of Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, Mexico
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