Okay subscribers.
Now for a totally new line of thought.... Viruses and arterial disease.
I recently had a 42 year old male present with acute carotidynia (severe
carotid artery pain) while suffering from presumed post-viral trigeminal
neuralgia (his wife had the same postviral neuralgia at the same time!)
It settled spontaneously in 1 week without any drama, however he had
lost his father (aged 35) following a ruptured carotid artery aneurysm.
I was tempted to give him oral Zovirax, though he didn't in fact need
it.
But next time I will, EBM or no EBM..
The following Medline abstract could act in my defence against the
Epidemiologists!
It makes very (if not extremely) interesting reading.
Comments??
Cytomegalovirus/herpesvirus and carotid atherosclerosis: the ARIC
Study.
J Med Virol Vol. 42 no. 1 pp. 33-7
MedlineŽ
MeSH Headings: Antibodies, Viral/blood Atherosclerosis/*etiology Carotid
Artery
Diseases/*etiology Case-Control Studies Cytomegalovirus/immunology
Cytomegalovirus
Infections/*complications Herpes Simplex/*complications Herpesvirus 1,
Human/immunology
Herpesvirus 2, Human/immunology Human Prospective Studies Risk Factors
Support, U.S. Gov't, P.H.S. United States
DATE: 1994 Jan
Abstract
Ubiquitous viruses such as members of the human herpes virus group,
particularly cytomegalovirus (CMV), have been
proposed to be clinically important agents inthe initiation and
progression of atherosclerosis. Antibodies to CMV and
herpessimplex virus type 1 (HSV1) and type 2 (HSV2) were determined in
340 matched case-control pairs from the
Atherosclerosis Risk in Communities (ARIC) Study. Cases were defined by
B-mode ultrasonography as persons with
thickened carotid artery walls consistent with early atherosclerosis but
without a history of cardiovascular disease. Controls
were defined as persons without thickened walls or history of
cardiovascular disease. The case-control odds ratio for CMV
antibodies was1.55 (P = .03), for HSV 1.41 (P = .07), and for HSV2 0.91
(P = .63). When adjustment was made for
potential confounders, the odds ratios were 1.36 for CMV (P = .24), 1.21
for HSV1 (P = .45), and 0.61 (P = .05) for
HSV2. These results suggest a modest association between CMV and
asymptomatic carotid wall thickening consistent with
early atherosclerosis.
Sorlie PD Adam E Melnick SL Folsom A Skelton T Chambless LE Barnes R
Melnick JL
Primary Author's Address: National Heart, Lung, and Blood Institute,
NIH, Bethesda, Maryland.
Medlars UID 94141476
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