Late-Stage Syphilis Linked to Increased Cardiovascular Risk and Mortality: JAMA

Dr Riya Dave

Late-Stage Syphilis Linked to Increased Cardiovascular Risk and Mortality: JAMA

Written By : Dr Riya Dave |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2026-04-22T09:00:10+05:30 | Updated On 22 April 2026 9:00 AM IST

A retrospective study published in JAMA Network Open found that U.S. adults with late-stage Syphilis have a significantly higher risk of major cardiovascular events, including stroke and heart attack, as well as increased mortality, compared to those without the infection. The study was conducted by Eli T. and colleagues.

Since the treponema pallidum bacterium causes poor health effects on the body's cardiovascular system during the third stage of the disease, the re-emergence of syphilis in the US has led to investigations on how the condition affects the cardiovascular system independent of the infection. This study adopted a retrospective cohort design with a long follow-up duration of 15 years from January 1, 2011, up to July 1, 2025. To select participants infected with syphilis, ICD-10 codes were used while the rest comprised a control group. All subjects were adults and had no record of cardiovascular disease before the beginning of the observation.

There were a total of 8,814 subjects enrolled in the study, of which 53.9% were females with an average age of 50.0 years. Participants who had syphilis (n = 1,469) and those who did not have it (n = 7,345) were carefully chosen to be comparable to each other with regard to their demographic data and the presence of other medical disorders. For accurate results, all outcomes were calculated by means of the Kaplan-Meier survival analysis with adjustment for BMI.

Key findings:

Patients with syphilis had more than twice the likelihood, as reflected by the HR, at 2.08 (95% CI, 1.47-2.94; P = 0.001).
Ischemic strokes were noted to be significantly more likely among these patients (HR, 1.53; 95% CI, 1.27-1.84), whereas hemorrhagic strokes were nearly two times more common (HR, 1.92; 95% CI, 1.23-2.99).
The risk of heart attack among syphilis patients was observed to be 33% greater (HR, 1.33; 95% CI, 1.06-1.67).
Infection was associated with a 28% increased risk of PAD (HR, 1.28; 95% CI, 1.01-1.62).

In summary, this study has shown that syphilis continues to be a strong determinant of heart disease and death in today’s world. It has been proved that syphilis infections were significantly linked with the development of different cardiovascular conditions, irrespective of other demographic variables or co-morbid conditions. This study highlights the need for early diagnosis and treatment of syphilis infections to avoid such problems.

Reference:

Tsakiris E, Feng H, Bidaoui G, et al. Adverse Cardiovascular Outcomes in Patients With Syphilis. JAMA Netw Open. 2026;9(4):e266771. doi:10.1001/jamanetworkopen.2026.6771

JAMA Network OpenSyphilisTreponema pallidumCardiovascular DiseaseIschemic StrokeAortic AneurysmMyocardial InfarctionPublic HealthNew Orleans Study

Source : JAMA Network Open

Dr Riya Dave

Dr Riya Dave has completed dentistry from Gujarat University in 2022. She is a dentist and accomplished medical and scientific writer known for her commitment to bridging the gap between clinical expertise and accessible healthcare information. She has been actively involved in writing blogs related to health and wellness.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751