The effects of human papillomavirus vaccination on cardiovascular diseases. The United States National Health and Nutrition Examination Survey

Abstract

Abstract Aims We investigated the association between HPV and CVDs in women with and without HPV vaccination. Methods and results We studied 9353 women aged between 18 to 59 years old who were tested for vaginal HPV DNA in the National Health and Nutrition Examination Survey (NHANES) 2003–2016. The CVDs were defined as the self-reported coronary heart diseases, heart attack, angina pectoris and stroke. The HPV vaccination status was extracted from the NHANES 2007–2016 database. The association between HPV and CVDs was studied using logistic regression, with adjustment for the potential confounders. Among the participants, 40.8% (95% CI, 39.4–42.4) were HPV DNA positive, and 3.0% (95% CI, 2.6–3.5) had CVDs. 9.0% (95% CI, 8.0–10.0) of women received the HPV vaccine. The presence of vaginal HPV infection was associated with CVD [OR=1.66, 95% CI (1.28–2.16), P<0.01], which remained significant [OR=1.53, (95% CI 1.13–2.07), P<0.01] after adjustment for sociodemographic characteristics, smoking, alcohol use, number of sexual partners, cervical cancer, BMI, hypertension, diabetes, and hyperlipidemia. Women younger than 38 years old showed a stronger association between HPV and CVDs [OR=2.15, 95% CI (1.01–4.77), P<0.01]. The association was absent among those who wereHPV vaccinated [OR= 0.44, 95% CI (0.07–2.79), P=0.83], but only present among those who were not [OR=1.60, 95% CI (1.15–2.24), P<0.01]. Conclusions In this large nationally representative survey, HPV infection was associated with CVDs. The association was absent in women vaccinated against HPV. Our findings regarding early HPV vaccinations may pave the way for new strategies for CVD prevention. Funding Acknowledgement Type of funding sources: None.