Doctor Hoa Tuan Ngoc, Medical Manager of VNVC Vaccination System, explains that shingles occurs when the varicella-zoster virus (VZV) reactivates after lying dormant in the sensory nerve ganglia of individuals who have previously had chickenpox. The virus travels along sensory nerves, potentially entering nearby blood vessels and causing inflammation and damage to the skin along the affected nerve's pathway, typically on one side of the body.

When the virus reaches areas like the chest, face, eyes, or neck, it can directly attack blood vessels in the brain or heart, causing vasculitis and other vascular complications. The body's immune system responds by releasing inflammatory cytokines, which can damage the lining of blood vessels and disrupt plaque, potentially leading to blood clot formation and blockage of coronary arteries, resulting in a heart attack.

Shingles can cause heart attack or stroke. Illustration: Vecteezy

Shingles can cause heart attack or stroke. Illustration: Vecteezy

A comparative study of 71,912 shingles patients in the US found that those with shingles had a 1.35 times higher risk of heart attack within 30 days of infection compared to those without shingles. Patients may experience high fever, rapid heartbeat, and increased tissue oxygen demand while blood flow to the heart decreases, especially in individuals with pre-existing coronary artery narrowing. This can lead to myocardial ischemia and heart attack.

Blood clots can block blood flow or weaken blood vessel walls, increasing the risk of rupture and stroke. A 2019 study showed that individuals with shingles, particularly ophthalmic shingles (affecting the eye), have a 1.3 to 4 times higher risk of stroke compared to those without shingles. This risk is significantly elevated in people under 40 and within one year of having shingles.

A 2017 study of 23,213 shingles patients in South Korea revealed a 41% increase in the risk of composite cardiovascular events, a 35% increase in stroke risk, and a 59% increase in heart attack risk among those with shingles.

Shingles is often accompanied by severe pain and prolonged stress, increasing sympathetic nervous system activity. This can elevate blood pressure and heart rate, further increasing the risk of cardiovascular events. Anxiety, insomnia, or depression following shingles can also strain the cardiovascular system.

In addition to cardiovascular complications, shingles can cause postherpetic neuralgia, encephalitis, meningitis, pneumonia, and facial paralysis. Individuals over 50 and those with underlying conditions like chronic kidney disease, chronic liver disease, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD), and others are at higher risk of developing complications from shingles.

Adults receive the shingles vaccine at VNVC Vaccination System. Photo: Moc Mien

Adults receive the shingles vaccine at VNVC Vaccination System. Photo: Moc Mien

Therefore, Doctor Ngoc recommends vaccination to prevent shingles and its complications. The vaccine is recommended for people 50 and older or those 18 and older at high risk due to underlying health conditions or immunosuppressive medications or treatments. The vaccine is 97% effective in preventing shingles in individuals 50 and older and 87% effective in those 18 and older with compromised immune systems due to underlying conditions. It also reduces the risk of postherpetic neuralgia and other complications by over 90%. The vaccination schedule consists of two doses administered 1-2 months apart.

In addition to vaccination, maintaining a healthy lifestyle with adequate rest, nutrition, and stress management, and avoiding stimulants is crucial. Individuals with underlying health conditions should adhere to their prescribed medications.

If diagnosed with shingles, prompt treatment, keeping the affected skin clean and well-ventilated, and avoiding scratching or rubbing the blisters to prevent infection are essential. Patients should also refrain from applying home remedies that contradict medical advice.

Binh Nguyen