Stress, Inflammation May Play Role
Varicella zoster virus-related blood vessel damage has been linked to stroke after shingles attacks, but this did not fully explain the high stroke risk seen in the study, Kang and colleagues wrote.
They added that the stress associated with shingles and the intense pain that can occur with outbreaks and following them could play a role, as could the inflammation that occurs with shingles outbreaks.
American Stroke Association spokesman Daniel Lackland, MD, says shingles patients and their doctors need to be aware of the new research.
Lackland is a professor of epidemiology and medicine at the Medical University of South Carolina in Charleston.
"This research needs to be confirmed, but it may be that shingles patients with risk factors for stroke need more aggressive monitoring and treatment than the average patient," he tells WebMD.
But he adds that the shingles-related stroke risk identified in the study is nowhere near as great as the risk associated with better-established stroke risk factors, like high blood pressure.
"The message doesn't change based on this study," he says. "Getting high blood pressure under control and treating other modifiable risk factors is what we have to focus on."
Early, aggressive treatment with antiviral drugs can lessen the length and severity of shingles attacks.
Kang says it remains to be seen if aggressive antiviral treatment can also lower stroke risk.
"This is a question we need to study," he says.