Association of hospital‐treated infectious diseases and infection burden with cardiovascular diseases and life expectancy

Abstract Background The association of a broad spectrum of infectious diseases with cardiovascular outcomes remains unclear. Objectives We aim to provide the cardiovascular risk profiles associated with a wide range of infectious diseases and explore the extent to which infections reduce life expectancy. Methods We ascertained exposure to 900+ infectious diseases before cardiovascular disease (CVD) onset in 453,102 participants from the UK Biobank study. Time‐varying Cox proportional hazard models were used. Life table was used to estimate the life expectancy of individuals aged ≥50 with different levels of infection burden (defined as the number of infection episodes over time and the number of co‐occurring infections). Results Infectious diseases were associated with a greater risk of CVD events (adjusted HR [aHR] 1.79 [95% confidence interval {CI} 1.74–1.83]). For type‐specific analysis, bacterial infection with sepsis had the strongest risk of CVD events [aHR 4.76 (4.35–5.20)]. For site‐specific analysis, heart and circulation infections posed the greatest risk of CVD events [aHR 4.95 (95% CI 3.77–6.50)], whereas noncardiac infections also showed excess risk [1.77 (1.72–1.81)]. Synergistic interactions were observed between infections and genetic risk score. A dose–response relationship was found between infection burden and CVD risks ( p ‐trend <0.001). Infection burden >1 led to a CVD‐related life loss at age 50 by 9.3 years [95% CI 8.6–10.3]) for men and 6.6 years [5.5–7.8] for women. Conclusions The magnitude of the infection‐CVD association showed specificity in sex, pathogen type, infection burden, and infection site. High genetic risk and infection synergistically increased the CVD risk.