Cytomegalovirus chronic infection as a risk factor for stroke: a prospective study

Chronic infection could be one of the possible causative factors involved as it causes dysfunction and inflammation of endothelium (Libby et al., 1997). Infection agents and viruses damage and transform the vascular wall, thus directly causing endothelium and smooth muscle cell dysfunction. Indirect influence on both atherosclerosis and atherothrombosis can occur by affecting leukocytes (including macrophages and lymphocytes, commonly found in atheromata) in the following ways: decrease of fibrinolytic activity, stimulation of procoagulant and cytotoxin production, and atherogenic changes in lipid metabolism. Infectious agents are essential for the immune system activation; it has been shown that flu vaccinated individuals less frequently develop acute vascular events, compared to unvaccinated people (Nichol et al., 2003; Smeeth et al., 2004).