According to a review study, having shingles as a young adult increases the risk of having a stroke, heart attack or transient ischemic attack years later.
Shingles is a viral infection that causes a painful rash. It’s caused by the same virus that causes chickenpox during childhood. After children recover, the chickenpox virus stays dormant in their nerve roots - and in some people, it may reactivate during adulthood to cause shingles.
The review study assessed over 100,000 people who had shingles and over 200,000 people of similar ages who did not have shingles. The results showed that people aged 18 to 40 years who had shingles were more likely to have a stroke, heart attack or transient ischemic attack years later, relative to people who had not had shingles.
On the other hand, people over 40 who had shingles were more likely to have a heart attack or transient ischemic attack, but not a stroke.
People under 40 years old were 74% more likely to have a stroke if they had had shingles previously - even after adjusting for risk factors such as obesity, smoking and high cholesterol. People under 40 were nearly 2.5 times more likely to have a transient ischemic attack if they had shingles and 50% more likely to have a heart attack.
In other words, anyone with shingles - especially younger people - should be screened for stroke risk factors.
The shingles vaccine has been shown to reduce the incidence of shingles by about 50%. Further studies are needed to determine whether vaccination can also reduce the incidence of stroke and heart attack in later years.
For instance, factors that increase the risk of stroke also increase the risk of shingles, so it’s not clear if vaccinating people for shingles will necessarily reduce the risk of stroke.
Current recommendations are that anyone 60 years and older should be vaccinated for shingles. However, the exact role for shingles vaccination in younger people with vascular risk factors still needs to be determined.