After you’ve dealt with chickenpox as a kid, you’re done with it forever, right? Wrong. For some folks, the virus that causes chickenpox can re-emerge later and cause shingles, a painful rash that can lead to serious complications if left untreated. The illness could also cause other problems to arise, too.

A new study published in the journal Neurology shows that if you develop shingles under the age of 40, you’re more likely to also have a mini-stroke, or transient ischemic attack, years later. In fact, your odds of having a mini-stroke increase by as much as 74 percent if you have had shingles. The risk of heart attack increased, as well.

The researchers found that the risk for stroke increases during the time a person is battling shingles, but they don’t know if the risk extends beyond that. So what’s the connection between a skin disease and a cardiovascular episode? Herpes zoster, as it is officially known, is more common in individuals who have risk factors for vascular disease. The link might be in the fact that shingles can cause inflammation of certain blood vessels. But the study results shouldn’t be interpreted as a cause-effect relationship. At the very least, those who have had shingles before age 40 should be extra vigilant about checking risk factors for stroke.

Shingles starts as a painful itch on one side of the body before the rash shows up. Those with compromised immune systems and a lot of stress are more likely to get it. As a preventive measure, the Centers for Disease Control and Prevention recommends the shingles vaccine for anyone over 60, which reduces the risk of developing shingles by half.

Before then, keep your heart healthy with regular exercise and a balanced diet to keep cardiovascular disease at bay.