HELICOBACTER-PYLORI INFECTION AND MORTALITY FROM ISCHEMIC-HEART-DISEASE - NEGATIVE RESULT FROM A LARGE, PROSPECTIVE-STUDY

Objective-To determine whether there is an independent association bet ween Helicobacter pylori infection of the stomach and ischaemic heart disease. Design-Prospective study with measurement of IgG antibody tit res specific to H pylori on stored serum samples from 648 men who died from ischaemic heart disease and 1296 age matched controls who did no t (nested case-control design). Subjects-21 520 professional men aged 35-64 who attended the British United Provident Association (BUPA) med ical centre in London between 1975 and 1982 for routine medical examin ation. Main outcome measure-Death from ischaemic heart disease. Result s-The odds of death from ischaemic heart disease in men with H pylori infection relative to that in men without infection was 1.06 (95% conf idence interval 0.86 to 1.31), In a separate group of 206 people atten ding the centre, plasma fibrinogen was virtually the same in those who were positive for H pylori (2.62 g/l) and those who were negative (2. 64 g/l). Conclusions-A study that by its size and design minimised bot h random error and socioeconomic bias found no relation between H pylo ri infection and ischaemic heart disease. The validity of the study wa s shown by its confirmation of the recognised association between H py lori infection and stomach cancer (odds ratio 4.0 (1.9 to 8.2); P < 0. 001). Eradication of H pylori infection may greatly reduce the inciden ce of stomach cancer, one of the most common causes of death from canc er worldwide, but it cannot be expected to have any effect in preventi ng ischaemic heart disease.