People who’ve had a bout of shingles may face a heightened risk of heart attack or stroke in later years, according to one large study.

Anyone who ever had chickenpox can develop shingles — a painful rash that is caused by a reactivation of the virus that causes chickenpox. About one-third of Americans will develop shingles in their lifetime, according to the U.S. Centers for Disease Control and Prevention.

The study, which included more than over 200,000 U.S. adults, found that those who’d suffered a bout of shingles were up to 38 percent more likely to suffer a stroke in the next 12 years, versus those who’d remained shingles-free.

Meanwhile, their risk of heart disease, which includes heart attack, was up to 25 percent higher.

The findings do not prove that shingles directly raises the risk of cardiovascular trouble. But it is biologically plausible, according to the researchers. The reactivated virus can get into the blood vessels, causing inflammation, and that could contribute to cardiovascular events such as heart attack and stroke.

Some prior studies found that cardiovascular risks can rise after shingles, but they have only looked at the short term.

“Our findings demonstrate that shingles is associated with a significantly higher long-term risk of a major cardiovascular event, and the elevated risk may persist for 12 years or more after having shingles,” said lead researcher Dr. Sharon Curhan of Brigham and Women’s Hospital in Boston.