Do UTIs Trigger Heart Attacks or Strokes?
Microbiologically confirmed urinary tract infections (UTIs) raised the risk for cardiovascular events such as heart attack and stroke, with both risks peaking in the first 7 days. The risks for heart attack and stroke rose again from 15 to 28 days and 29 to 90 days after the infection, respectively.
METHODOLOGY:
Researchers in the UK conducted a self-controlled case series analysis to estimate associations between microbiologically confirmed UTIs and the risk for the first acute myocardial infarction (MI) and stroke.
They included Welsh residents aged 30 years or older who experienced a first MI (n = 2320) or stroke (n = 2840) along with microbiologically confirmed UTIs between 2010 and 2020.
A UTI counted as new only if at least 7 days passed since a previous episode, and UTIs within 7 days were counted as the same episode.
The risks for MI and stroke among individuals with a UTI were assessed during a 7-day prerisk period before diagnosis — to capture infections that began prior to consultation — and at 1-7, 8-14, 15-28, and 29-90 days after the infection.
The risks measured in these predefined windows were then compared with each patient's risk for stroke or MI at baseline.
TAKEAWAY:
The risk for MI was elevated in the first 7 days following a UTI (incidence rate ratio [IRR], 2.49; 95% CI, 1.65-3.77) and again during days 15-28 after the infection (IRR, 1.60; 95% CI, 1.10-2.33).
Similarly, the risk for stroke was elevated in the first 7 days (IRR, 2.34; 95% CI, 1.61-3.40) and during days 29-90 (IRR, 1.26; 95% CI, 1.05-1.52) after an UTI.
Among individuals with a clinically suspected UTI, the adjusted IRR for MI within the first 7 days was 1.26 (95% CI, 0.52-3.05) in those with mixed bacterial growth on culture, 1.83 (95% CI, 1.54-2.18) in those without a urine culture, and 3.69 (95% CI, 2.28-5.96) in those with no bacterial growth on culture; the risk for stroke was also elevated in all these instances.
Compared with infections by other bacteria, Escherichia coli infections carried a lower risk for MI but a higher risk for stroke.
IN PRACTICE:
"We observed an increased risk of MI and stroke immediately following a UTI," the authors wrote.
SOURCE:
This study was led by Nicola F. Reeve, Cardiff University, Cardiff, Wales. It was published online on June 30, 2025, in BMJ Open.
LIMITATIONS:
The precise date of the onset of UTI was unknown, and only the date of diagnosis was recorded. Additionally, the study may have missed UTIs for which people did not seek medical care or those unrecorded in the Welsh Results Reporting Service prior to 2015. The use of routine data also meant that outcome ascertainment relied on accurate coding.
DISCLOSURES:
This study was supported by a grant from the British Heart Foundation. One author declared being a member of the Statistical Advisory Board for BMJ Open.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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