The study, led by researchers at Tulane University and published in JAMA Network Open, used electronic health records from three New Orleans hospitals within a single health system. Investigators reviewed 15 years of data beginning in 2011 and compared 1,469 adults with syphilis to 7,345 people without the infection, excluding anyone with preexisting cardiovascular disease. The analysis adjusted for other factors before estimating risks.
After adjustment, syphilis was associated with substantially higher risks of major cardiovascular events: roughly twice the risk of aortic aneurysm or dissection, a 53% higher risk of ischemic stroke, a 92% higher risk of hemorrhagic stroke, a 31% higher risk of heart attack, and a 28% higher risk of peripheral artery disease. The study also reported a notably higher risk of death. The increased risk was concentrated in patients whose infection progressed longer than a year. The researchers did not find significant links to heart failure or atrial fibrillation.
Lead author Eli Tsakiris said the work is one of the few large modern studies to show syphilis can be associated with catastrophic cardiovascular and neurologic effects. Corresponding author Amitabh C. Pandey noted this is an early step toward understanding how infections such as syphilis may raise cardiovascular risk, possibly through chronic inflammation. Public health data from the CDC show an 80% rise in US syphilis cases from 2018 to 2022, with especially high rates in Southern states. Existing antibiotic treatment is usually effective; sometimes a single shot of penicillin can eradicate the disease. The researchers say more work is needed to learn whether treatment can reduce longer-term cardiovascular risks.
Difficult words
- electronic health record — digital files that store patients' medical historyelectronic health records
- adjust — to take other factors into accountadjusted
- ischemic — caused by blocked blood flow to tissue
- hemorrhagic — caused by bleeding in the brain
- aortic aneurysm — a dangerous bulge in the body's main artery
- peripheral artery disease — narrowing of blood vessels outside the heart
- chronic inflammation — long-lasting body response to injury or infection
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How might rising syphilis rates affect public health given the study's findings about cardiovascular risks?
- Do you think earlier or wider treatment could reduce long-term cardiovascular risks from infections like syphilis? Why or why not?
- What public health actions could be effective in areas with especially high syphilis rates?
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