Does the HPV virus raise heart disease risk in women?

Slightly, yes. In nearly 3 million Swedish women, those with a recorded HPV infection had about a 7% higher risk of developing heart disease (hazard ratio 1.07) and about a 25% higher risk of dying from it (hazard ratio 1.25). In real numbers, that worked out to roughly 5 extra heart disease cases per 10,000 women per year.

HPV, or human papillomavirus, is the infection most people know as the cause of cervical cancer and the reason the HPV vaccine exists. Whether it does anything to the heart and blood vessels has been an open question. Earlier studies hinted at a link, but they were small, drawn from selected clinic populations, and could not separate the virus from everything else a woman inherits or grows up with.

This study went after both problems at once. Researchers at Karolinska Institutet used Sweden’s national health registers, which capture essentially the whole country, and then ran a second analysis comparing infected women against their own sisters.

What the data show

The team identified 497,445 women with a newly detected HPV infection between 2006 and 2024 and matched each one to five women of the same age without infection, for a comparison group of 2,487,225.

Over follow-up, 28,793 heart disease events occurred in the infected women and 128,373 in the uninfected group. That is a rate of 8.27 versus 7.93 per 1,000 women per year. After adjusting for social and demographic factors, HPV vaccination, other chronic diseases, and parents’ medical history, infected women had about a 7% higher risk of new heart disease, and the true figure is very likely between 5% and 8% higher (95% CI 1.05 to 1.08). The absolute gap was 0.53 extra cases per 1,000 women per year, or about 5 per 10,000.

Deaths tell a slightly different story. There were 1,221 heart-related deaths among infected women and 4,941 among the uninfected, a rate of 33.73 versus 29.39 per 100,000 women per year. That is about a 25% higher risk of dying from heart disease, very likely somewhere between 16% and 34% higher (95% CI 1.16 to 1.34), and an absolute difference of 6.71 extra deaths per 100,000 women per year.

Why the first year matters most

Timing is the most interesting part of this paper. Both risks were concentrated right after the infection was recorded and then faded.

During the first year of follow-up, the risk of new heart disease was about 43% higher (hazard ratio 1.43, very likely 38% to 48% higher), and the risk of heart-related death was about 86% higher (hazard ratio 1.86). That death estimate is far less certain, with a range running from about 41% higher to about 145% higher. After that first year, the heart disease figure dropped to about 2% higher (hazard ratio 1.02) and the death figure to about 21% higher (hazard ratio 1.21).

A short, front-loaded spike that settles down is the pattern you would expect from an acute inflammatory hit or from the stress of a new diagnosis, not from decades of slow artery damage.

The sister comparison

The strongest design feature here is the sibling analysis. Researchers compared 143,787 infected women to their 174,637 full sisters without HPV. Sisters share genes, childhood, and a great deal of household environment, so if the link were really explained by family background, it should collapse in this comparison.

It did not. Infected women still had about a 5% higher risk of heart disease than their own sisters (hazard ratio 1.05, very likely 1% to 8% higher) and about a 25% higher risk of heart-related death (hazard ratio 1.25), though that death estimate was imprecise, ranging from about 1% to about 53% higher.

Dr. Kumar’s Take

The honest summary is that this is a real signal and a small one. A 7% relative increase sounds meaningful until you convert it: about half an extra case per 1,000 women per year. The authors themselves put the population-attributable fraction at 1.16% for new heart disease and 4.12% for heart disease death, meaning HPV accounts for a small slice of the total burden.

What I find worth attention is the shape of the curve rather than its height. Infections that cause a burst of inflammation have been tied to short-term cardiovascular events before, and a 43% jump in the first year that then nearly disappears fits that picture. It also raises a mundane alternative: women who get tested and diagnosed are entering the medical system, so some of that first-year bump could reflect detection rather than damage.

This is observational data, so it cannot prove HPV causes heart disease. The authors also note that HPV infections were probably missed in some women, which would push the measured association toward zero rather than inflate it. Nothing here changes what a woman should do about HPV. It does add one more argument for prevention.

Practical Takeaways

If you have had an abnormal HPV test, treat the standard heart risk factors you can control, such as blood pressure, smoking, and activity, rather than worrying about the virus itself, since the absolute increase in risk is small.
The HPV vaccine and routine cervical screening remain the two proven ways to reduce HPV-related disease, and this study gives no reason to change either recommendation.
If you develop chest pain, unusual shortness of breath, or other cardiac symptoms in the months after any significant infection, get evaluated rather than assuming it is unrelated.

FAQs

Does the HPV vaccine lower heart disease risk?

This study did not test that. Vaccination status was one of the factors the researchers adjusted for, which means it was accounted for in the statistics rather than examined as a treatment. Answering the vaccine question properly would take a study that follows vaccinated and unvaccinated women forward and counts cardiac events in each group. What this paper supports is narrower: the association between a recorded infection and later heart problems was not explained by whether a woman had been vaccinated.

Why compare women to their own sisters?

Sisters share about half their DNA plus the same parents, home, and much of their early environment. If two sisters differ in one exposure but match on all of that background, a difference in outcomes is harder to blame on genes or upbringing. It is one of the cleaner tools observational research has for a question that cannot be tested in a trial. The link held in this comparison, which is why the finding deserves more weight than a typical registry association.

Does this apply to men?

The study included only women, because HPV testing in Sweden runs through the cervical screening program, which is how these infections get recorded in the first place. Men get HPV too, and it causes throat and other cancers in them, but there is no equivalent routine testing program that would generate comparable register data. Whether the same short-term cardiac pattern shows up in men is unanswered here.

Bottom Line

Across nearly 3 million Swedish women, a recorded HPV infection came with about a 7% higher risk of developing heart disease and about a 25% higher risk of dying from it, and the association survived a comparison against the women’s own sisters. The effect was concentrated in the first year after infection and then largely faded. The absolute numbers are small, roughly 5 extra cases per 10,000 women per year, so this is not a reason for alarm. It is a reason to take the inflammatory aftermath of infection seriously as a cardiovascular question.

Read the full study