For US Healthcare Professionals
For US HCPs
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Understanding the risk and impact of shingles and RSV on your patients with CVDs
Certain chronic conditions, including cardiovascular diseases, have been associated with an increased risk of shingles and severe RSV.1,2
In 2025, tens of millions of adults aged 50 years and older are estimated to have cardiovascular diseases, including hypertension. More than half (51.2%) of the adults aged ≥50 years in the United States are estimated to have hypertension.3*
- *
Estimated number of adults aged ≥50 years with select comorbidities are based on prevalence estimates obtained from a retrospective, cross-sectional analysis of pooled 2011-2020 data from the National Health and Nutrition Examination Survey (NHANES) on self-reports of diagnoses by an HCP. The study included 26,280 adults aged ≥20 years, with population weights provided by NHANES used to subsequently extrapolate findings to the entire 2020 US non-institutionalized adult population. Prevalence estimates of comorbidities were then extrapolated to 2025 population estimates obtained from the US Census Bureau.3
CVD=cardiovascular disease; HCP=healthcare professional; RSV=respiratory syncytial virus.
CVDs and the risk of shingles
Patients aged ≥50 years are at increased risk of shingles.4 Cardiovascular conditions have been associated with an increased risk of shingles.1
The risk of shingles sharply increases starting at age 50 and continues to increase with age.4 In addition to age, cardiovascular conditions have been identified as an additional risk factor.1
CARDIOVASCULAR CONDITIONS HAVE BEEN ASSOCIATED WITH A
34
INCREASED RISK OF DEVELOPING SHINGLES1†‡
- Pooled effect estimate (16 studies) assessing the risk of shingles in patients with cardiovascular conditions vs without: RR: 1.34 (95% CI, 1.17, 1.54)1
†Data from a meta-analysis assessing risk factors for HZ. The analysis included a total study population of 198,751,846 individuals, with 3,768,691 HZ cases across 88 studies (68 cohort and 20 case-control studies) from 1966 to 2019. The populations in these studies ranged from people aged 3 months to 104 years. Eighteen risk factors were identified in the meta-analysis. Limitations included the following: most studies were observational and had a higher likelihood of bias; the majority of studies used administrative data, which is subject to miscoding, errors, and variation between practitioners; finally, heterogeneity was high across studies.1
‡Cardiovascular conditions included in each study in the meta-analysis varied and included heart disease, heart failure, hypertension, hyperlipidemia, stroke, atrial fibrillation/flutter, and other cardiovascular disease.1
THE ODDS OF STROKE WERE
53
HIGHER AMONG PATIENTS WITH SHINGLES THAN AMONG PATIENTS WHO DID NOT HAVE SHINGLES: OR: 1.53 (95% CI, 1.01, 2.33)5§
- Herpes zoster has been associated with a short-term increased risk of stroke5§
- In a population-based study, in adults aged 50 years and older, 0.7% of patients had a stroke within 3 months post-shingles episode, compared with 0.4% of people who did not have shingles5
§Data from a population-based community cohort study (January 1986 to October 2011) in adult residents of Olmsted County, Minnesota, aged 50 years and older; this retrospective study compared rates of post-HZ stroke with a cohort of age- and sex-matched individuals. Risk was adjusted for several known risk factors and confounding factors for stroke. Among the patients with HZ (n=4478), 0.7% had a stroke within 3 months post-HZ compared with 0.4% in the non-HZ cohort study (n=16,800). Patients with a history of stroke were excluded from this analysis.5
- CI=confidence interval; HZ=herpes zoster; OR=odds ratio; RR=risk ratio.
CVD and the risk of RSV
Cardiovascular disease can impact the risk of severe RSV.6,7
ADULTS WITH CORONARY ARTERY DISEASE WERE
3.7x-6.5x
MORE LIKELY TO BE HOSPITALIZED FROM RSV7¶
- Based on IRRs observed in adults aged 50-64 years and ≥65 years with and without CAD7
¶A prospective surveillance study was conducted in the United States to estimate the incidence of RSV-associated hospitalization among adults aged ≥18 years with and without certain comorbidities (N=1099) over 3 seasons (2017-2018, 2018-2019, and 2019-2020).7
- CAD=coronary artery disease; ICD-9-CM=International Classification of Diseases, Ninth Revision, Clinical Modification; ICD-10-CM=International Classification of Diseases, 10th Revision, Clinical Modification; IRR=incidence rate ratio; RSV-NET=Respiratory Syncytial Virus Hospitalization Network.
Are you familiar with shingles and RSV preventive care options for your patients with CVD?
References
Marra F, Parhar K, Huang B, Vadlamudi N. Risk factors for herpes zoster infection: a meta-analysis. Open Forum Infect Dis. 2020;7(1):1-8.
Respiratory syncytial virus infection (RSV). RSV in adults. Centers for Disease Control and Prevention. Reviewed July 8, 2025. Accessed July 9, 2025.
Data on file, GSK.
Shingles (herpes zoster). Clinical overview of shingles (herpes zoster). Centers for Disease Control and Prevention. Reviewed June 27, 2024. Accessed August 15, 2025.
Yawn BP, Wollan PC, Nagel MA, Gilden D. Risk of stroke and myocardial infarction after herpes zoster in older adults in a US community population. Mayo Clin Proc. 2016;91(1):33-44.
Woodruff RC, Melgar M, Pham HG, et al; Respiratory Syncytial Virus Hospitalization Surveillance Network (RSV-NET). Acute cardiac events in hospitalized older adults with respiratory syncytial virus infection. JAMA Intern Med. 2024;184(6):602-611.
Branche AR, Saiman L, Walsh EE, et al. Incidence of respiratory syncytial virus infection among hospitalized adults, 2017–2020. Clin Infect Dis. 2022;74(6):1004-1011.