Objective To analyze the distribution of helicobacter pylori (HP) infection in the primary prevention population of atherosclerotic cardiovascular disease (ASCVD) in the community, and to explore the possible influencing factors of HP infection in relation to ASCVD and insulin resistance.

Methods A total of 536 hypertensive patients who met the ASCVD primary prevention criteria and had a long-term history of low-dose aspirin use were included from the community. According to the 13C urea breath test results, the participants were divided into the HP infection group and the HP non-infection group. General demographic data, glucose and lipid metabolism-related indicators, insulin resistance index, and carotid intima-media thickness (CIMT) measurements were collected from both groups. Propensity score matching (PSM) was used to eliminate confounding factors such as age, and multiple linear regression analysis was performed to evaluate the impact of HP infection on metabolic indicators.

Results After PSM, the body fat percentage, fasting insulin, glycated hemoglobin, insulin resistance index, insulin sensitivity index, fasting blood glucose, and CIMT in the HP infected group were significantly higher than those in the HP uninfected group (P ＜ 0.05). Multiple linear regression analysis showed that, after controlling for confounding factors such as age, gender, and body mass index, HP infection was positively correlated with insulin resistance index, glycated hemoglobin, and CIMT (P ＜ 0.05-P ＜ 0.01).

Conclusions HP infection is an independent risk factor for insulin resistance and early atherosclerosis in ASCVD primary prevention population.