Cytomegalovirus infection is associated with an increase in systolic blood pressure in older individuals

Abstract

Background: Cytomegalovirus (CMV) is a chronic infection that is widely distributed in the population. CMV infects a range of tissues, including endothelium, and viral replication is suppressed by the host immune system. Infection is associated with increased risk of mortality from vascular disease in older people, but the mechanisms behind this have not been determined.Aim: We investigated the association between CMV infection and cardiovascular phenotype in a cohort of healthy elderly donors.Design: CMV serostatus and cardiovascular parameters were determined in the Lothian Birth cohort, which comprises 1091 individuals aged 70 years in whom many environmental, biochemical and radiological correlates of vascular function have been determined.Methods: CMV serostatus was determined by enzyme-linked immunosorbant assay and correlated with a range of biochemical and phenotypic measures.Results: Sixty-five percent of participants were CMV seropositive, which indicates chronic infection. The mean sitting systolic blood pressure (SBP) was 149.2 mmHg in CMV seropositive individuals compared with 146.2 mmHg in CMV seronegative subjects (SD 18.7 vs. 19.7; P < 0.017). This association between CMV infection and SBP was not attenuated after adjustment for a wide range of biological and socio-economic factors.Conclusions: These data show that CMV infection is associated with an increase in SBP in individuals at age 70 years. The magnitude is comparable to environmental variables such as obesity, diabetes or high salt intake. This is the first evidence to show that a chronic infection may be an important determinant of blood pressure and could have significant implications for the future management of hypertension.

Human cytomegalovirus epidemiology and relationship to tuberculosis and cardiovascular disease risk factors in a rural Ugandan cohort

“…Further studies have implicated chronic HCMV infection as a risk factor for cardiovascular disease (CVD); a recent meta-analysis of studies conducted in HICs, estimated a 22% increased relative risk of CVD with exposure to HCMV [ 13 ]. In a UK setting, HCMV infection was associated with the development of arteriosclerosis [ 14 ] and a 3mmHg increase in systolic blood pressure among older individuals [ 15 ]. As Africa undergoes what has been described as an ‘epidemiological shift’ from infectious to non-communicable disease [ 16 ], an estimated 1.2 million deaths in Africa were attributed to CVD in 2004 [ 17 ].…”

Cytomegalovirus serostatus, inflammation, and antibody response to influenza vaccination in older adults: The moderating effect of beta blockade

“…The findings also call for additional research into the interaction of CMV with other, non-immune health risks such as mood (depression, anxiety; Phillips, Carroll, Khan, & Moss, 2008) or hypertension (Firth et al, 2016) in the promotion of immune senescence. In the present sample, individuals without either CMV or beta-blockers had the best antibody persistence.…”

Productive Cytomegalovirus Infection Is Associated With Impaired Endothelial Function in ST-Elevation Myocardial Infarction

“…24 Also, we found a significant prevalence in the number of copies of cytomegaloviral DNA in patients who were older and hypertensive, which corresponds to the previous studies that showed the positive correlation of antibodies to cytomegalovirus and cytomegaloviral microRNA with arterial blood pressure, especially in older patients. 38,67,68 Moreover, one of the possible mechanisms of the development of hypertension in patients with cytomegalovirus infection could also be the development of endothelial dysfunction with the synthesis of proinflammatory cytokines and renin by endothelial cells infected with cytomegalovirus. 69 Endothelial function plays an important role in patients with atherosclerosis.…”