1 week ago
Shingrix Linked to Lower Heart Attack and Stroke Risk
Shingrix is a vaccine that helps protect older adults from shingles.
A new study looked at the health records of 70,000 people in the United States.
People who received Shingrix had fewer heart attacks, strokes and cases of heart failure than expected.
Their risk was 12% lower during the first three-and-a-half years after vaccination.
After seven years, the lower risk was 4%.
This does not prove that the vaccine directly prevented these conditions because the study was not a randomized trial.
Scientists think the benefit could come from preventing shingles or from effects on the immune system.
More clinical trials are needed to know how strong the connection really is.
A study of 70,000 U.S. adults aged 60 and older linked Shingrix vaccination to a 12% lower cardiovascular-event risk during the first three-and-a-half years.
The events included heart attacks, heart failure and strokes, while the reduction was 4% by the end of seven years.
Researchers compared people vaccinated before and after the 2017 U.S. switch from Zostavax to Shingrix to reduce potential distortion from comparing vaccinated and unvaccinated groups.
Dr Maxime Taquet said clinical trials could confirm benefits potentially comparable to those of daily blood-pressure medication.
Researchers cautioned that the findings are observational, and randomized trials are needed to establish whether Shingrix directly protects against cardiovascular disease.
- Who
- Researchers led by Dr Maxime Taquet studied 70,000 adults aged 60 and above; Dr Hugo Pedder commented independently.
- What
- The study associated the Shingrix shingles vaccine with lower risks of cardiovascular events, including heart attacks, strokes and heart failure.
- Where
- The health records were from the United States; the study was published in Nature Medicine.
- When
- Participants were followed for seven years after vaccination, with the strongest reported association during the first three-and-a-half years.
- Why
- Researchers are investigating whether preventing shingles or changing immune-system inflammation could explain the association.
Evidence Suggests Cardiovascular Benefit
Caution Until Trials Confirm It
Strength of the association
Evidence Suggests Cardiovascular Benefit
Researchers found that Shingrix recipients had a 12% lower cardiovascular-event risk in the first three-and-a-half years, and Dr Maxime Taquet said the possible effect could be comparable to blood-pressure medication.
Caution Until Trials Confirm It
The absolute change in risk was small, and the study was observational rather than a randomized controlled trial, so it cannot establish that Shingrix caused the reduction.
Possible explanation
Evidence Suggests Cardiovascular Benefit
A more effective shingles vaccine may reduce cardiovascular risk by preventing shingles, which researchers said could itself raise the risk of heart and vascular disease.
Caution Until Trials Confirm It
Researchers also proposed broader immune-system effects, but the biological explanation remains uncertain and is still being investigated.
Need for further evidence
Evidence Suggests Cardiovascular Benefit
Dr Hugo Pedder said the study provides some of the best-quality observational evidence supporting a difference between recombinant and live vaccines for cardiovascular outcomes.
Caution Until Trials Confirm It
Pedder also said a randomized trial would be the best way to determine confidently whether recombinant vaccines provide these benefits compared with live vaccines.
Key facts
- Study population
- 70,000 U.S. adults aged 60 and older
- Initial follow-up finding
- A 12% lower risk of cardiovascular events during the first three-and-a-half years after Shingrix vaccination
- Seven-year finding
- A 4% lower risk of cardiovascular disease by the end of the seven-year follow-up
- Events examined
- Heart attacks, heart failure and strokes
- Study method
- Researchers compared outcomes around the rapid U.S. switch from Zostavax to Shingrix in 2017
- Evidence status
- Observational evidence; randomized controlled trials are needed for more definitive conclusions
- Vaccine rollout
- The United Kingdom is gradually offering Shingrix to people aged 65 to 79
Quotes
Dr Maxime Taquet
Clinical lecturer at the University of Oxford and lead researcher
“If confirmed in clinical trials, vaccinating older adults against shingles could prevent hundreds of thousands of coronary heart diseases, strokes and cases of heart failure worldwide, making it one of the most impactful interventions we could offer to protect both the brain and the heart in later life. The effect might be enormous.”
freepressjournal.in
“A randomised trial would be the best way to confidently answer whether recombinant vaccines do provide the benefits seen here versus live vaccines, but until such a trial is done this study provides some of the best-quality observational evidence supporting an effect of recombinant v live vaccines for cardiovascular outcomes.”
freepressjournal.in
Sources
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