Abstract Body: Introduction: Chronic Helicobacter pylori (H. pylori) infection, a ubiquitous enteric bacterium, may lead to systemic inflammation, possibly increasing the risk of hypertension (HTN) and type 2 diabetes mellitus (T2D). Studies linking H. pylori infection with HTN and T2D have produced mixed results.
Objective: To determine if H. pylori seropositivity is associated with elevated blood pressure (BP), hemoglobin A1c (HbA1c), and annual change in SBP, DBP, and HbA1c over a median of 10 years using Add Health.
Methods: Wave IV (2008-2009) Add Health participants were tested for immunoglobulin antibodies to H. pylori with a binary cutoff for seropositivity of 13.217 U/mL. Systolic BP (SBP), diastolic BP (DBP), and HbA1c were measured at Waves IV and V (2016-2018). Annual rates of change in SBP, DBP, and HbA1c were calculated by dividing the difference in value between Waves IV and V by the number of years elapsed for each participant. Prevalence differences (PD), differences in point estimates, and 95% confidence intervals (CI) were determined using multivariable linear regression models accounting for Add Health's complex sampling design and adjusting for age, sex, race/ethnicity, education, income, childhood socioeconomic status, body mass index, smoking, alcohol use, and medication use.
Results: The median ages in Wave IV and V were 28 and 37 years, respectively, with 54% being female. In the final analytic sample (N=4,600), 958 (21%) participants were seropositive for H. pylori. Seropositive participants were more likely to be non-Hispanic Black (24% vs 9.3%) and less likely to be college graduates (12% vs 19%) than seronegative individuals. In adjusted models, there were no differences in SBP (PD -0.79 mmHg (CI -2.79, 1.22)), DBP (PD -0.65 mmHg (CI -2.79, 1.22)), and HbA1c (PD -0.01% (CI -0.08, 0.05)) by H. pylori seroprevalence. The adjusted annual mean (standard deviation) change in SBP (-0.12 (0.81) vs 0.03 (0.85)), DBP (0.23 (0.60) vs 0.22 (0.59)), and HbA1c (-0.02 (0.05) vs -0.02 (0.04)) from Wave IV to V was not different between seropositive and seronegative participants.
Conclusions: In a cohort of younger adults, H. pylori seropositivity was not associated with higher BP or HbA1c or differences in annual rate of change in SBP, DBP, and HbA1c over a median of 10 years. Further research is needed to understand the relationship between H. pylori infection and cardiometabolic disorders over a longer period of time as individuals age into mid to late life.