Increased Risk of Stroke Following Shingles

Recent data about herpes zoster - or shingles, as it is commonly known - has indicated that there is an increased risk of suffering a stroke in the months following a bout of shingles.

A study involving over 6,500 adults in the UK showed that in the first month following herpes zoster, patients were at the highest risk of having a stroke. However, over a six month period that risk gradually decreased.

Shingles, a virus that reveals itself as a painful rash or blisters on the skin, is caused by the reactivation of the varicella-zoster virus. It has been proposed that in addition to this symptom, the virus could increase the stroke risk through viral invasion of arterial walls and induction of vasculopathy.

National Stroke Foundation Clinical Council Member Dr Bruce Campbell said that although a stroke post shingles is still unlikely, GPs should be wary of the association.

“This is a timely reminder for GPs to ensure they are regularly monitoring stroke risk factors in older patients and discussing lifestyle modifications that can be made to help reduce the risk of stroke, which is Australia’s second leading cause of death and a leading cause of disability," Dr Campbell said.

Each year in Australia there are about 97,600 GP consultations for shingles by people aged over 50. Due to the country's large ageing population, it is estimated that by age 85, one in two adults will have been affected by shingles.

The most common post-shingles complication is postherpetic neuralgia (PHN), a debilitating neuropathic pain which studies have shown can last an average of three and a half years. Most patients reported experiencing pain for “most” or “all of the time”, with a significant impact on quality of life.

Flinders University's  Associate Professor Litt, Discipline of General Practice, said greater awareness of the potential shingles-related complications is also needed amongst healthcare professionals.

“With the incidence of shingles on the increase in older Australians, and a growing body of evidence in relation to the longer-term impact of potential complications, GPs need to ensure they are across the data and understand that the impact on quality of life following shingles can be significant,” Professor Litt said