World J Gastroenterol 2014; 20(19): 5625-5631. doi 10.3748/wjg.v20.i19.5625.

Blood pressure and stature in Helicobacter pylori positive and negative persons

Kopacova M1, Koupil I2, Seifert B3, Skodova Fendrichova M1, Spirkova J4, Vorisek V4, Rejchrt S1, Douda T1, Tacheci I1, Bures J1

1 2nd Department of Internal Medicine – Gastroenterology, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Hospital, Hradec Kralove, Czech Republic

2 Centre for Health Equity Studies, Stockholm University, Karolinska Institute, Stockholm, Sweden

3 Institute of General Practice, First Faculty of Medicine, Charles University, Praha, Czech Republic

4 Institute of Clinical Biochemistry and Diagnostics, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Hospital, Hradec Kralove, Czech Republic

 

Abstract

To evaluate vital signs and body indices in Helicobacter pylori positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1,818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38,147 subjects. Helicobacter pylori infection was investigated by means of a 13C-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of Helicobacter pylori infection was 30.4% (402/1,321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with Helicobacter pylori positive adults showing an increase of 0.6 kg/m2 in body mass index. Once adjusted for age and gender, we found a difference in height between Helicobacter pylori positive and Helicobacter pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with Helicobacter pylori positive children and adolescents being on average 3.5 cm shorter. Helicobacter pylori positive adults were significantly older compared to Helicobacter pylori negative subjects. Once adjusted for age and gender, Helicobacter pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. Chronic Helicobacter pylori infection appeared to be associated with short stature in children. Helicobacter pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.

PMID: 24914321

 

Supplement

It has been hypothesised that chronic Helicobacter pylori infection may be associated with and/or contribute towards several extra-gastric diseases, including ischaemic heart disease, arterial hypertension, cerebral non-cardioembolic ischaemic stroke, peripheral arterial disease, obesity, metabolic syndrome and short stature, for review see ref. 1. A few interesting new papers were published recently. Lu et al. (2) studied pepsinogen I / pepsinogen II ratio in patients with hypertension. The ratio was significantly lower in Helicobacter pylori positive subjects but there was no difference in severity of hypertension. However, pepsinogen I / pepsinogen II ratio was lower in individuals with hypertensive nephropathy and hypertensive retinopathy. The authors suggest that the ratio detection may be valuable for diagnostic screening for hypertensive organ damage (2). Vahdat et al. (3) found that coinfection with Chlamydia pneumoniae and Helicobacter pylori showed a significant association with essential hypertension (compared with double seronegativity), independent of cardiovascular risk factors and chronic low-grade inflammation. Nevertheless, analysing the aggregate number of pathogens (chronic infection with cytomegalovirus, Chlamydia pneumoniae, herpes simplex virus 1 and Helicobacter pylori), the pathogen burden was not associated with hypertension (3). Even more, seropositivity for Helicobacter pylori does not necessarily indicate current infection (4). Naja et al. (5) revealed no association of Helicobacter pylori and hypertension among Lebanese adults. Helicobacter pylori was more prevalent in patients with permanent atrial fibrillation but there was no significant impact on blood pressure (6). Xu et al. (7) concluded their study that Helicobacter pylori infection might contribute, at least in part, to the cognitive decline in patients with vascular dementia but there was no association of Helicobacter pylori infection and hypertension (7).

 

fig1

Figure 1: Blood pressure (mean ± standard deviation) in 497 children and adolescents (≤ 17 year-old). Difference is not statistically significant.

SBP: systolic blood pressure

DBP: diastolic blood pressure

Hp posit.: Helicobacter pylori positive subjects (n = 26)

Hp negat.: Helicobacter pylori negative subjects (n = 471)

 

Importance of the Study

Our group accomplished a large multi-centre epidemiologic study on the prevalence of Helicobacter pylori and basic vital signs in the Czech Republic, a Central European country, in 2012 (1). The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants, smaller towns (≤ 20 000 inhabitants) with surrounding villages and rural areas, and were spread over the whole country, corresponding well to the geographical distribution of the Czech population. Based on the great number of study subjects, we conclude that chronic Helicobacter pylori infection do not influence blood pressure either in adults or children and adolescents, see Figures 1 and 2. Despite the substantial decrease of Helicobacter pylori infection in the Czech Republic over the past decade (8,9), the prevalence of arterial hypertension did not change significantly (1,10). This fact further supports our conclusion that chronic Helicobacter pylori infection does not play any role in the pathogenesis of arterial hypertension.

 

fig2

Figure 2: Blood pressure (mean ± standard deviation) in 1,321 adults (≥ 18 year-old). Difference is not statistically significant.

SBP: systolic blood pressure

DBP: diastolic blood pressure

Hp posit.: Helicobacter pylori positive subjects (n = 402)

Hp negat.: Helicobacter pylori negative subjects (n = 919)

 

References

1. Kopacova M, Koupil I, Seifert B, Skodova Fendrichova M, Spirkova J, Vorisek V, Rejchrt S, Douda T, Tacheci I, Bures J. Blood pressure and stature in Helicobacter pylori positive and negative persons. World J Gastroenterol 2014; 20: 5625-5631.
2. Lu C, Jia H, Xu A, Tang J, Xu G, Yue W, Zhang J. Helicobacter pylori infection and pepsinogen levels have clinical significance in hypertension patients. Int J Clin Exp Med 2014; 7: 5675-5680.
3. Vahdat K, Pourbehi MR, Ostovar A, Hadavand F, Bolkheir A, Assadi M, Farrokhnia M, Nabipour I. Association of pathogen burden and hypertension: the Persian Gulf Healthy Heart Study. Am J Hypertens 2013; 26: 1140-1147.
4. Shin DW, Kwon HT, Kang JM, Park JH, Choi HC, Park MS, Park SM, Son KY, Cho B. Association between metabolic syndrome and Helicobacter pylori infection diagnosed by histologic status and serological status. J Clin Gastroenterol 2012; 46: 840-845.
5. Naja F, Nasreddine L, Hwalla N, Moghames P, Shoaib H, Fatfat M, Sibai A, Gali-Muhtasib H. Association of H. pylori infection with insulin resistance and metabolic syndrome among Lebanese adults. Helicobacter 2012; 17: 444-451.
6. Wang D-Z, Chen W, Yang S, Wang J, Li Q, Fu Q, Li S-J, Chen B-X. Helicobacter pylori infection in Chinese patients with atrial fibrillation. Clin Interv Aging 2015; 10: 813-819.
7. Xu Y, Wang Q, Liu Y, Cui R, Zhao Y. Is Helicobacter pylori infection a critical risk factor for vascular dementia? Int J Neurosci 2015; epub ahead of print.
8. Bures J, Kopacova M, Koupil I, Vorisek V, Rejchrt S, Beranek M, Seifert B, Pozler O, Zivny P, Douda T, Kolesarova M, Pinter M, Palicka V, Holcik J, and European Society for Primary Care Gastroenterology. Epidemiology of Helicobacter pylori infection in the Czech Republic. Helicobacter 2006; 11: 56-65.
9. Bures J, Kopacova M, Koupil I, Seifert B, Skodova Fendrichova M, Spirkova J, Vorisek V, Rejchrt S, Douda T, Kral N, Tacheci I. Significant decrease in prevalence of Helicobacter pylori in the Czech Republic. World J Gastroenterol 2012; 18: 4412-4418.
10. Kopacova M, Bures J, Koupil I, Rejchrt S, Vorisek V, Seifert B, Pozler O, Zivny P, Douda T, Palicka V, Holcik J and European Society for Primary Care Gastroenterology. Body indices and basic vital signs in Helicobacter pylori positive and negative persons. Eur J Epidemiol 2007; 22: 67-75.

 

Acknowledgements

The study was supported by Research project PRVOUK P37-08 (from Charles University in Praha, Faculty of Medicine at Hradec Kralove, Czech Republic).

 

Contact:

Professor Marcela Kopacova, MD, PhD, 2nd Department of Internal Medicine – Gastroenterology, University Hospital, Sokolska 581, 500 05 Hradec Kralove, Czech Republic. E-mail: marcela.kopacova@fnhk.cz

 

 

 

 

 

 

 

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