Heart disease: HPV may increase risk of death 4-fold

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• About 12% of all women globally have a detectable infection of HPV, which currently has no cure.
• High risk forms of HPV have been linked to an increased risk of a number of cancers.
• Researchers have found evidence suggesting women with a high risk strain of HPV are at a four-time higher risk of dying from cardiovascular disease.

Researchers estimate about 12% of all women around the world have a detectable infection of the human papillomavirus (HPV).

HPV is considered the most common sexually transmitted infection (STI). Previous research shows HPV is the most common pathogen responsible for female cancers.

Men can also contract HPV.

There is currently no cure for HPV. The majority of people with HPV will not show symptoms and most cases go away on their own.

However, some forms of highrisk HPV do not go away and have been linked to an increased risk of cervical cancer, oropharyngeal cancer, anal cancer, penile cancer, vulvar cancer, and vaginal cancer.

Now, researchers from the Sungkyunkwan University School of Medicine in Seoul, Korea have found evidence suggesting women with a high risk strain of HPV are at a four-time higher risk of dying from cardiovascular disease.

The study was recently published in the European Heart Journal.

How HPV and heart disease are linked

According to Dr. Seungho Ryu, professor in the Center for Cohort Studies at the Total Healthcare Center in Kangbuk Samsung Hospital at Sungkyunkwan University School of Medicine in Seoul, Korea, and co-lead author of this study, this study was inspired by growing evidence of a potential link between high risk strains of HPV and cardiovascular diseases.

“With HPV’s widespread prevalence and its established link to certain cancers, our goal was to delve into its wider health impacts, particularly its role in cardiovascular mortality,” Dr. Ryu told Medical News Today.

“This study sought to uncover new modifiable risk factors for heart disease, targeting gaps not explained by traditional risk factors such as smoking, high cholesterol, hypertension, and diabetes. Despite significant progress in managing these known risk factors, heart disease remains a leading cause of death.”
— Dr. Seungho Ryu

“Notably, conventional risk factors do not account for all cases of heart disease; approximately 20% occur in individuals without these conditions, underscoring the importance of exploring additional variable risk factors,” he said.

This is not the first study to look at a link between HPV and heart disease. A study published in June 2019 found HPV might be associated with coronary artery disease among women in the climacteric stage of their lives — the time encompassing perimenopause, menopause, and postmenopause.

And research published in March 2023 reported an association between HPV infection and cardiovascular diseases in women, however, the association was not significant among women vaccinated against HPV.

What is high risk HPV?

For this study, Dr. Ryu and his team analyzed data from more than 163,000 young or middle-aged Korean women who had no diagnosis of cardiovascular disease at the study’s start. Study participants received a number of health screening tests, including a cervical screening for 13 high risk strains of HPV.

“In our research, we focused on 13 high risk strains of HPV, including HPV 16 and HPV 18, leveraging secondary health checkup data that encompasses tests for high risk HPV as part of cervical cancer screening,” Dr. Ryu explained. “The fundamental distinction between high risk and low risk HPV strains is their oncogenic potential.”

“High-risk HPV strains have the ability to trigger cellular changes that lead to malignancies, notably cervical cancer, by interacting with and disrupting cellular tumor suppressor proteins,” he continued. “Furthermore, high risk HPV strains, particularly HPV 16 and HPV 18, can be implicated in cardiovascular diseases.”

Dr. Ryu said that high risk HPV may increase cardiovascular disease mortality risk through mechanisms involving chronic inflammation and direct impacts on atherosclerosis.

“The presence of high risk HPV strains has been associated with systemic inflammation, a key factor in the development of atherosclerotic cardiovascular disease,” he continued. “This suggests that HPV infection could contribute to the progression of cardiovascular diseases by exacerbating inflammatory processes.”

4 times greater risk of dying from heart disease with HPV

During the study, participants were followed for up to 17 years, during which time they periodically received health checks.

According to researchers, the cardiovascular disease death risk for young, healthy women is about 9.1 in 100,000.

When taking into account other factors known to increase heart disease risk — such as obesity, smoking, diabetes, and high blood pressure — scientists found that women with high risk HPV had a 3.91 times greater risk of having blocked arteries, a 3.74 times higher risk of dying from cardiovascular disease, and a 5.86 times increased risk of dying from a stroke compared to women who did not have a high risk HPV infection.

The researchers also reported these risks were even higher in study participants who had both a high risk HPV infection and obesity.

“Our findings found a strong association between high risk HPV infection and increased cardiovascular disease (CVD) mortality, particularly atherosclerotic cardiovascular disease. HPV is predominantly known for its role in causing cervical and other cancers, so uncovering its significant impact on cardiovascular mortality opens new avenues for understanding the systemic effects of this virus.”
— Dr. Seungho Ryu

“While our study provides significant insights into the association between high risk HPV and cardiovascular mortality, it also highlights several areas where further research is needed,” Dr. Ryu said.

“The limitations regarding the demographic focus and the lack of data on vaccination status and specific HPV genotypes point to the necessity for more comprehensive, longitudinal studies. These future studies should aim to include a broader population, including men, to fully understand the impact of HPV infection on cardiovascular health,” he added.

More diversity in study population needed

After reviewing this study, Dr. Nicole Weinberg, a board certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, told MNT this research is part of the current trend of examining chronic inflammation and zeroing in on what that inflammation is and how it can be treated.

“Something like HPV we know can be identified and treated in certain capacities, and so it’s pretty exciting to me as a clinical cardiologist who sees a lot of patients to know that is a source of chronic inflammation in a patient that could be identified and then possibly treated,” Dr. Weinberg said.

MNT also spoke with Dr. G. Thomas Ruiz, a board certified OB/GYN and lead OB/GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who said he was highly skeptical that there is a link between HPV and cardiovascular disease.

“Based on just one study in this population, I don’t know if you can make the link to HPV and cardiovascular disease — more work has to be done,” Dr. Ruiz continued. “The study was done in Korea so it’s a homogenous population. Whenever you’re dealing with studies in a homogenous population, you want as much diversity in the study as possible, so you want to see it extended to a more of a mixed background.”

“I’d like to see them be able to replicate their data on someone with BMIs less than 30 and high risk HPV positive, [t]hat to me might be more beneficial,” he added.