Infections in childhood, such as typhoid fever, measles, chicken pox, bronchitis and dengue, are linked with an increased risk of early heart attacks, a new study reveals.

According to the findings presented at the Acute Cardiovascular Care 2015, these infections may lead to premature acute coronary syndromes (ACS). Doctors use the term ACS to describe various heart conditions including a heart attack.

The researchers conducted a population-based case-control study in Makassar, Indonesia, with participants who were mostly male with an average age of 47 years old. There were two groups involved in the study: one comprising of 153 patients with a first ACS before the age of 56 years; and another set of 153 individuals with no history of ACS. The team defined severe infection as fever for three days or more, or hospitalisation due to infectious disease.

Information on the history of infection was obtained using a detailed questionnaire and interviews with the two groups of participants, plus their family members (parents, aunts, uncles, siblings). The researchers studied infections suffered by the participants during infancy and pre-school, elementary school, junior high school and senior high school. From these data, the team calculated an infection score ranging from 0 to 4, with positive early-life infection defined as a score of 2 or more.

Using an interviewed-questionnaire and diagnostic test results, the researchers gathered data about traditional cardiovascular disease, or CVD risk factors, such as age, sex, occupation, monthly income, educational level, dietary pattern and physical activity. They also considered the participants’ smoking status, family history of heart disease, diabetes, sudden cardiac death, and known history of hypertension and diabetes.

In their analysis, the team found that infection experienced in childhood and adolescence was associated with a three-fold higher occurrence of premature ACS later in life. They also found that the risk of premature ACS in patients with childhood infections increased with more CVD risk factors.

“One explanation is that infection initiates chronic inflammation and atherosclerosis in the arteries. It could be that infection modifies CVD risk factors and leads to ACS,” says Dr Andriany Qanitha, a PhD candidate at the Academic Medical Centre in Amsterdam, The Netherlands, who presented the study.

Qanitha says that while they conducted the study in Indonesia, their findings may apply to other countries in South-East Asia where infectious disease is still prevalent. She recommends having a combined strategy from the government and policymakers to tackle infectious disease and CVD.

CVD is the leading cause of deaths worldwide, including in Australia where it kills one person every 12 minutes. The new study reveals that unhealthy lifestyles in adulthood appear to compound the risk of early heart attack. According to the Heart Foundation, lifestyle risk factors of CVD include obesity, physical inactivity, low fruit and vegetable intake, alcohol and smoking.

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