Background and Aims High-risk human papillomavirus (HR-HPV) infection—a well-established risk factor for cervical cancer—has associations with cardiovascular disease (CVD). However, its relationship with CVD mortality remains uncertain. This study examined the associations between HR-HPV infection and CVD mortality. Methods As part of a health examination, 163 250 CVD-free Korean women (mean age: 40.2 years) underwent HR-HPV screening and were tracked for up to 17 years (median: 8.6 years). National death records identified the CVD mortality cases. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD mortality were estimated using Cox proportional hazard regression analyses. Results During 1 380 953 person-years of follow-up, 134 CVD deaths occurred, with a mortality rate of 9.1 per 105 person-years for HR-HPV(−) women and 14.9 per 105 person-years for HR-HPV(+) women. After adjustment for traditional CVD risk factors and confounders, the HRs (95% CI) for atherosclerotic CVD (ASCVD), ischaemic heart disease (IHD), and stroke mortality in women with HR-HPV infection compared with those without infection were 3.91 (1.85–8.26), 3.74 (1.53–9.14), and 5.86 (0.86–40.11), respectively. The association between HR-HPV infection and ASCVD mortality was stronger in women with obesity than in those without (P for interaction = .006), with corresponding HRs (95% CI) of 4.81 (1.55–14.93) for obese women and 2.86 (1.04–7.88) for non-obese women. Conclusions In this cohort study of young and middle-aged Korean women, at low risks for CVD mortality, those with HR-HPV infection had higher death rates from CVD, specifically ASCVD and IHD, with a more pronounced trend in obese individuals.

中文翻译：

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人乳头瘤病毒感染与心血管死亡率：一项队列研究

背景和目的 高危人乳头状瘤病毒 (HR-HPV) 感染是一种公认​​的宫颈癌危险因素，与心血管疾病 (CVD) 相关。然而，其与 CVD 死亡率的关系仍不确定。本研究探讨了 HR-HPV 感染与 CVD 死亡率之间的关联。方法 作为健康检查的一部分，163 250 名无 CVD 的韩国女性（平均年龄：40.2 岁）接受了 HR-HPV 筛查，并进行了长达 17 年的跟踪（中位数：8.6 年）。国家死亡记录确定了心血管疾病死亡病例。使用 Cox 比例风险回归分析估计 CVD 死亡率的风险比 (HR) 和 95% 置信区间 (CI)。结果 在 1 380 953 人年的随访期间，发生 134 例 CVD 死亡，其中 HR-HPV(−) 女性死亡率为每 105 人年 9.1 例，HR-HPV(+) 女性死亡率为每 105 人年 14.9 例。 ） 女性。调整传统 CVD 危险因素和混杂因素后，HR-HPV 感染女性与未感染女性相比，动脉粥样硬化 CVD (ASCVD)、缺血性心脏病 (IHD) 和卒中死亡率的 HR (95% CI) 为 3.91 (1.85 –8.26)、3.74 (1.53–9.14) 和 5.86 (0.86–40.11)。肥胖女性中 HR-HPV 感染与 ASCVD 死亡率之间的相关性比非肥胖女性更强（交互作用 P = 0.006），肥胖女性相应的 HR (95% CI) 为 4.81 (1.55–14.93)，肥胖女性为 2.86 (95% CI)。 1.04–7.88）对于非肥胖女性。结论 在这项针对 CVD 死亡率低风险的中青年韩国女性的队列研究中，HR-HPV 感染者的 CVD 死亡率较高，特别是 ASCVD 和 IHD，肥胖个体的趋势更为明显。