Helicobacter pylori seroprevalence and its association with prevalent and incident blood pressure and haemoglobin A1c in the US-based National Longitudinal Study of Adolescent to Adult Health

Introduction Chronic Helicobacter pylori ( H. pylori ) infection may increase the risk of hypertension (HTN) and type 2 diabetes mellitus (T2D), but association studies have produced mixed results. This cross-sectional and longitudinal study examined whether H. pylori seropositivity was associated with elevated blood pressure (BP), haemoglobin A1c (HbA1c), prevalent and incident HTN, and T2D over 10 years. Methods Add Health, a US-based cohort study, has followed participants from adolescence in the mid-1990s (wave I) through early midlife (wave V) in 2016–2018. Wave IV (n=15 701) participants were tested for immunoglobulin antibodies to H. pylori with a binary seropositivity cut-off (≥13.217 U/mL). Systolic BP (SBP), diastolic BP (DBP) and HbA1c were measured at waves IV and V. Prevalent HTN was defined as SBP ≥140 mm Hg and/or DBP ≥90 mm Hg, self-reported HTN or HTN medication use at wave IV. Prevalent T2D was defined as HbA1c ≥6.5%, self-reported T2D or T2D medication use at wave IV. Incident HTN and T2D at wave V were defined among participants without HTN or T2D at wave IV. Multivariable linear and Poisson regression models determined prevalence differences (PD) and incidence rate ratios, respectively, with 95% CIs. Results The median (IQR) ages in waves IV and V were 28 (27, 30) and 37 (36, 39) years, respectively, with 54% female in 4600 participants; 958 (20.8%) were seropositive for H. pylori . In adjusted models, seropositive participants had lower mean SBP (PD −1.62, 95% CI −3.06 to –0.18) than seronegative participants. H. pylori seropositivity was not associated with DBP, HbA1c, prevalent and incident HTN, or T2D. Conclusions In a cohort of younger adults, H. pylori seropositivity was not associated with prevalent or incident HTN and T2D. More studies are required to understand the interaction between infectious disease and chronic cardiometabolic disorders and how it can change as people age.