H. pylori May Be Linked with Heart Disease

H. pylori May Be Linked with Heart Disease
Possible cardiovascular benefit of eradicating these bacteria
may be yet another reason to take mastic
By Edward R. Rosick

Mastic (Pistacia lentiscus)
nother ancient idea is finding new life in Hollywood. This time, it’s the concept that certain things or events in life can have far-reaching effects never initially imagined. In the current movie The Butterfly Effect, a young man attempts to change his current life by going back in time to modify events that will impact his life in later years. Of course, it being a movie, things don’t initially work out as planned for the young protagonist, but they fall conveniently into place at the end.

While clichés are nothing new in Hollywood, the idea that certain microorganisms can influence and contribute to a multitude of human diseases has sometimes been met with resistance by the medical community. In fact, it wasn’t too many years ago that mainstream physicians scoffed at the idea that Helicobacter pylori, a helical bacterium found in the human digestive tract, is a principal cause of several gastrointestinal ailments, including ulcers. Yet there is now abundant scientific evidence indicating that H. pylori is indeed a central player in the pathogenesis of ulcers, and new research is showing that it may also be linked to high cholesterol levels and heart disease.

Tiny H. pylori Causes Big Trouble

Until the 1990s, most doctors believed that peptic ulcers (ulcers of the stomach or duodenum) were caused by stress, bad diet, smoking, or a variety of other causes. However, research that began in the early 1980s on the definitive cause of ulcers showed that H. pylori—which is now thought to infect about 3 billion people (half the world’s population)—is the actual culprit in ulcer formation.

In the stomach, H. pylori generates an enzyme, urease, that releases ammonia. The ammonia shields the bacteria from attack by the stomach’s digestive juices (mainly hydrochloric acid), enabling them to burrow through the layer of protective pink mucus that lines the stomach wall. They then embed themselves in the sensitive underlying tissue, where they can cause the painful irritation called gastritis. Given enough time, they can damage this sensitive tissue and the mucus above it so severely that the result is an ulcer (which may or may not be painful and which may or may not bleed).

Triple Therapy Is Expensive and Carries Risks

Over the centuries, doctors have tried (largely unsuccessfully) many treatments for ulcers, including milkshakes, antacids, and the avoidance of spicy foods. We now know, however, that the most effective way to treat ulcers is to eradicate H. pylori from the digestive tract—including the mouth, where the bacteria can also thrive. The conventional medical treatment for H. pylori is called “triple therapy”—the use of three prescription drugs (generally two antibiotics and a proton pump inhibitor) for 2 to 3 weeks.

Although this treatment is usually effective in eradicating the bacteria, it’s also expensive, and it can cause multiple side effects (including nausea, vomiting, and diarrhea). Furthermore, it kills beneficial digestive-tract bacteria, and it can contribute to the growing problem of antibiotic resistance.

Mastic Eradicates H. pylori Naturally and Safely

Fortunately for those with a more holistic bent, the use of mastic gum is a natural, safe way to eradicate H. pylori. Mastic gum is the aromatic resin of the mastic tree (Pistacia lentiscus), which is native to the Mediterranean region and is found primarily on the Greek island of Chios. There are records of the use of mastic gum as far back as the first century for alleviating abdominal pain and urinary distress, and the gum has long been used as a whitening agent and toothpaste for oral hygiene. It has also commonly been used in Greece as a flavoring agent for foods.

It wasn’t until the 1980s, however, that researchers in the Middle East showed that mastic gum is a potent antibacterial agent against various types of pathogenic bacteria, most notably H. pylori. A more recent study, published in 1998 in the prestigious New England Journal of Medicine, showed that 1 gram per day of mastic can effectively treat peptic ulcers.1

Can Pneumonia Lead to Heart Disease?

Chlamydia pneumoniae
Other infectious microorganisms besides H. pylori have been investigated for their possible role in the pathogenesis of coronary heart disease (CHD). One of these is the bacterium Chlamydia pneumoniae, which is a common cause of community-acquired pneumonia and bronchitis. One study of C. pneumoniae in this regard was a case-control study that used data from the Helsinki Heart Study, which was originally designed to examine the effectiveness of the drug gemfibrozil in treating CHD.1 The researchers examined data from 143 CHD patients and 103 controls. The results suggested that chronic C. pneumoniae infection might be a significant risk factor for the development of CHD. Other studies, however, have not found a significant association between C. pneumoniae infection and heart disease.2

Incidentally, microorganisms (bacteria, viruses, or fungi) that cause pneumonia can more easily survive and multiply in the respiratory system when periodontal infection has the upper hand. This is also true of other pathogenic microorganisms, such as those responsible for bronchitis. Because mastic, especially when used as a chewing gum, has been found to reduce the levels of oral bacteria in the upper gastrointestinal tract, it is conceivable that its regular use might lessen the chances of upper respiratory tract infections. Confirming studies are needed.

So what is one to make of the contradictory evidence described above? Well, it’s always useful to remember that medical research is both art and science, neither of them perfect, and different researchers can reach different conclusions from the same evidence. And since some evidence does indicate that infectious agents such as H. pylori and C. pneumoniae may somehow be involved in the complex origins of CHD, it makes sense to try to avoid them.

Beyond the usual healthy lifestyle choices—not smoking, eating a well-balanced diet, and getting regular exercise—you can take nutritional supplements that enhance your immune system, as well as supplements, such as mastic gum, that have antibacterial action. And keep a sharp eye out for medical news that might affect your ability to stay healthy and happy.

  1. Saikku P, Leinonen M, Tenkanen L, et al. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Study. Ann Int Med 1992;116(4):273-8.
  2. Hoffmeister A, Rothenbacher D, Wanner P, et al. Seropositivity to chlamydial lipopolysaccharide and Chlamydia pneumoniae, systemic inflammation, and stable coronary artery disease. J Am Coll Cardiol 2000;35(1):112-8.

H. pylori May Affect the Heart As Well As the Gut

Although there aren’t many physicians in practice today who would question the fact that H. pylori is the principal cause of ulcers, there is still plenty of skepticism concerning other diseases in which this widespread bacterium may be implicated. One of these is coronary heart disease (CHD), the number one killer of Americans. Since the mid-1990s, several studies have shown a provocative link between H. pylori infection and the risk for developing heart disease.

Among the earliest of these was a case-control study* that compared 111 CHD patients (white males aged 45–65) with 74 controls who did not have CHD.2 The results showed that 59% of the men with CHD had evidence of H. pylori infection, compared to a 39% infection rate in the controls. This difference was judged to be significant, based on statistical analysis of the data and controlling for other variables.

*A case-control study is one in which the researchers study a group of people who already have the outcome of interest (in this case, CHD) and compare their lifestyle factors and exposures (to H. pylori, e.g.) with those of a similar group of people who do not have the outcome, looking for differences that might explain why one group has the outcome and the other does not. This kind of study has both strengths and weaknesses.

A more recent paper also examined the association between H. pylori infection and CHD.3 In this much larger case-control study, 1122 survivors of heart attacks (men and women, aged 30–49 years) were compared to age- and sex-matched controls. In addition, this study compared 510 age- and sex-matched pairs of siblings. As in the previous study, H. pylori infection was more significantly associated with the patients who had CHD, leading the authors to conclude, “In the context of results from other relevant studies, these two studies suggest a moderate association between coronary heart disease and H. pylori seropositivity that cannot be fully accounted for by other risk factors.” (Seropositivity means that the blood serum tests positive for the presence of the bacterium.)

Does H. pylori Affect Cholesterol Levels?

If H. pylori is indeed associated with CHD, the question arises as to how it causes damage to the cardiovascular system. Although we don’t yet know the answer, there is some tantalizing evidence indicating that H. pylori may increase the risk for CHD by modifying blood cholesterol levels.

“. . . these two studies suggest a
moderate association between CHD
and H. pylori . . . that cannot be fully
accounted for by other risk factors.”

One study compared 116 CHD patients with 116 controls matched for age and sex.4 Although the results showed only a minor association between H. pylori infection and CHD, it did show a more robust correlation between higher levels of triglycerides (fats) and lower levels of HDL-cholesterol (the “good cholesterol”) in the H. pylori-infected patients. Based on these findings, the authors of the study concluded, “. . . the results are consistent with the hypothesis that H. pylori infection might modify the serum lipid concentrations in a way that could increase the risk of CHD.”

Keep an Open Mind

Until more scientifically robust studies are done, it’s too early to tell whether eliminating H. pylori from your gut and your mouth will help protect you from heart disease. It’s good to remember, though, that only a few years ago, the idea that a bacterium was the major cause of ulcers and that a gum resin from a tree in Greece could help heal them was met with ridicule from most physicians.

Now we know about the positive effects of mastic on gastrointestinal and oral health, and future research might perhaps validate the idea that, by eradicating H. pylori, it may also play a role in helping to prevent heart disease.


  1. Huwez FA, Thirlwell D, Cockayne A, Ala’Aldeen DAA. Mastic gum kills Helicobacter pylori. New Engl J Med 1998;339:1946.
  2. Mendall MA, Goggin PM, Molinezus N, et al. Relation of Helicobacter pylori infection and coronary artery disease. Brit Heart J 1994;71(5):437-9.
  3. Danesh J, Youngman L, Clark S, et al. Helicobacter pylori infection and early onset myocardial infarction: case-control and sibling pairs study. Brit Med J 1999;319(30):1157-62.
  4. Niemela S, Karttunen T, Korhonen T, et al. Could Helicobacter pylori infection increase the risk of coronary heart disease by modifying serum lipid concentrations? Heart 1996;75(6):573-5.

Dr. Rosick is an attending physician and clinical assistant professor of medicine at Pennsylvania State University, where he specializes in preventive and alternative medicine. He also holds a master’s degree in healthcare administration.

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