Objective-To investigate the relation between seropositivity to chronic infections with Helicobacter pylori and Chlamydia pneumoniae and both coronary heart disease and cardiovascular risk factors.Design-Cross sectional study of a population based random sample of men. Coronary heart disease was assessed by electrocardiography, Rose angina questionnaire, and a history of myocardial infarction; serum antibody levels to H pylori and C pneumoniae were measured, risk factor levels determined, and a questionnaire administered.Setting Seropositivity to C pneumoniae was independently associated with raised fibrinogen and malondialdehyde concentrations.Conclusions-Both H pylori and C pneumoniae infections are associated with coronary heart disease. These relations are not explained by a wide range of confounding factors. Possible mechanisms include an increase in risk factor levels due to a low grade chronic inflammatory response.

Background-There is evidence suggesting that early life experience may influence adult risk of coronary heart disease (CHD). Chronic bacterial infections have been associated with CHD. Objective-To determine whether Helicobacter pylori, a childhood acquired chronic bacterial infection, is associated with an increased risk of coronary heart disease in later life. We used a case-control comparison to investigate whether H pylori infection was associated with adult CHD. We also studied possible associations of Hpylori infection with cardiovascular risk factors in the control population. Patients and methods PATlENTSWe studied men aged 45-65. The controls came from a single general practice screening clinic and the cases from a series of consecutive patients referred to the cardiology clinic of a local teaching hospital with angiographically confirmed CHD (stenosis >70% in one coronary artery). Potential controls were excluded if they had a firm diagnosis of CHD. METHODSAll subjects completed a questionnaire and 10 ml of serum was drawn and stored at -20°C. Blood pressure was measured in the general practice when the patient was seated. One observer used the same mercury sphygmomanometer throughout the study.We measured H pylori specific IgG antibody titres by an in-house enzyme linked immunoadsorbent assay (ELISA) in duplicate, using a partially purified antigen as described previously. Results were analysed by multiple logistic regression using GLIM7 and multiple regression using the GLM proceedure in SAS. In the logistic regression models, age was grouped into four categories (45-49, 50-54, 55-59, 60-65) and current social class was grouped into six categories according to the Registrar-General's 1980 classification.

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This prospective study aimed to compare serology for Helicobacter pyloni with two, symptom questionnaires in screening patients before direct access endoscopy. Methods were compared in terms of the number of endoscopies saved and pathology missed in 315 patients referred to a gastroenterology unit by 65 local GPs. The serology used was based on an acid glycine extract of H pylori. One in-house questionnaire was based on the Glasgow dyspepsia (GLADYS)

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