With the success of antiretroviral therapy (ART), people living with HIV (PLWH) now enjoy longer life expectancies than ever before. However, this increased lifespan has brought a new challenge: a significantly higher risk of early cardiovascular disease (CVD).

Research shows that HIV-positive individuals are 1.5 to 2 times more likely to develop heart disease at a younger age compared to HIV-negative individuals. This article explores the underlying causes, scientific findings, and most importantly, how to reduce that risk through prevention and lifestyle changes.

Why Does HIV Increase Heart Disease Risk?

Cardiovascular disease in HIV patients is multifactorial, meaning it’s influenced by a mix of biological, lifestyle, and treatment-related factors.

1. Chronic Inflammation & Immune Activation

Even with effective ART and undetectable viral load, HIV causes persistent low-grade inflammation in the body. This leads to:

• Damage to blood vessel linings (endothelium)
• Increased plaque formation
• Accelerated atherosclerosis (hardening of arteries)

2. Immune System Dysfunction

HIV affects CD4+ T-cells, weakening the immune system. This dysfunction can:

• Promote autoimmune reactions
• Make the body less effective at repairing vascular damage

3. Side Effects of Antiretroviral Therapy (ART)

Some older or specific ART drugs (especially protease inhibitors and abacavir) are associated with:

• Increased cholesterol and triglyceride levels
• Insulin resistance
• Elevated risk of metabolic syndrome

4. Higher Prevalence of Traditional Risk Factors in PLWH

People living with HIV often have a higher rate of:

• Smoking
• Diabetes
• Obesity
• Sedentary lifestyle
• Co-infections like Hepatitis B/C, which can indirectly impact cardiovascular health

5. HIV-Associated Lipodystrophy

This condition, caused by some ART medications, leads to abnormal fat distribution and metabolic changes, further increasing the risk of heart disease.

What Does the Research Say?

Several key studies have demonstrated the link between HIV and heart disease:

• The REPRIEVE Trial (NIH, ongoing) is investigating whether statins can prevent heart disease in HIV patients.
• A study published in JAMA Cardiology (2020) found that HIV-positive individuals had a 50–100% higher risk of heart attack than the general population.
• A 2023 report in The Lancet HIV showed increased arterial stiffness and vascular inflammation in young adults with HIV — even those on effective ART.

In short, heart disease now rivals opportunistic infections as a leading cause of morbidity in aging HIV patients.

Early Warning Signs & Screening

HIV patients often experience “silent” heart disease, where symptoms may not be obvious until major events like a heart attack or stroke occur. Regular screening is essential.

Doctors typically monitor:

• Blood pressure
• LDL/HDL cholesterol
• Blood sugar and insulin levels
• C-reactive protein (CRP) — marker of inflammation
• Carotid intima-media thickness (CIMT) — ultrasound measure of artery wall thickening

Prevention Strategies: How to Lower the Risk

Fortunately, many of the risks can be controlled with the right interventions.

1. Stick to Effective ART

• Modern ART regimens are safer and more heart-friendly than earlier generations.
• Staying virally suppressed reduces inflammation and immune activation.
• If you’re on older ART (e.g., abacavir, lopinavir), talk to your doctor about switching.

2. Adopt Heart-Healthy Habits

3. Control Blood Pressure & Cholesterol

• Use statins if needed — they not only lower cholesterol but also have anti-inflammatory benefits in HIV.
• REPRIEVE trial is evaluating long-term statin use in HIV for prevention even in low-risk patients.

4. Manage Diabetes and Insulin Resistance

• Monitor A1C and fasting glucose regularly.
• Adopt a low-glycemic index diet and stay active.

5. Address Mental Health & Stress

• Chronic stress and depression (common in HIV) can raise cortisol and BP.
• Practice mindfulness, therapy, and sleep hygiene.

Summary Table: HIV and Heart Disease

Final Thoughts

People living with HIV now live longer — but with longevity comes greater vulnerability to chronic illnesses like heart disease. The good news is that with early screening, modern ART, and healthy lifestyle choices, heart disease in HIV-positive individuals is largely preventable.

HIV-positive people are living longer than ever because of therapies that prevent the growth of the virus. But these patients deal with more heart troubles and barriers to treatment than other individuals, according to the American Heart Association (AHA).

A scientific statement published in June 2019 in the journal Circulation highlighted that three-quarters of people over the age of 45 who are living with HIV are experiencing significantly more heart attacks, heart failure, and strokes earlier in life compared with those who don’t have HIV.

“Chronic inflammation and immune activation [or response] appear to be the primary drivers of high heart disease risk in HIV,” says Matthew Feinstein, MD, chair of the writing group for the statement and assistant professor of medicine and preventive medicine at the Feinberg School of Medicine at Northwestern University in Chicago.

He stresses that HIV treatment is essential, not only for controlling the virus, but also for reducing chronic inflammation and problems with immune regulation.

“Several studies have now shown that worse HIV control is associated with higher risks for heart disease,” Dr. Feinstein told Everyday Health. “So the first and most important step in preventing heart disease in HIV is getting the HIV under control with the right medications prescribed by HIV specialists and primary care doctors.”

Addressing Common Heart Disease Factors

The statement authors also observed that people living with HIV more often had factors commonly associated with heart troubles, such as heavy alcohol use, substance abuse, mood and anxiety disorders, low levels of physical activity, and poor cardiorespiratory fitness.

About 4 out of 10 are smokers, according to a nationally representative sample of HIV patients.

Quitting tobacco use, eating a balanced diet (such as the DASH diet or Mediterranean diet), and staying physically active can help lower risk, notes Feinstein.

Sarah Samaan, MD, a cardiologist with Baylor Scott & White Legacy Heart Center in Plano, Texas, who was not an author on the statement, has seen many HIV patients benefit from statin drugs to lower cholesterol and medication to lower blood pressure.

“Since some HIV medications can raise the risk of side effects from other drugs, it’s important to discuss the options for treatment with a knowledgeable physician,” say Dr. Samaan. “A good pharmacist can also help to ensure that the drugs that are prescribed are safe and appropriate.”

Living Longer But With More Health Problems

In an accompanying patient perspective published by the American Heart Association, Jules Levin, the founder and executive director of the National AIDS Treatment Advocacy Project (NATAP), expressed his concerns about the high numbers of serious medical problems in older people with HIV compared with the general population.

According to NATAP, those with HIV over 60 years old have an average of three to seven health conditions in addition to being HIV-positive. Comorbidities include heart attacks, strokes, heart failure, kidney disease, frailty, and bone diseases. Also, many take 12 to 15 drugs daily.

“Most people don’t know that HIV is causing accelerated aging,” says Levin, who has been living with HIV for 35 years. “Within a few years of initial infection, the immune system senescence [deterioration with age] sets in right away. Once people with HIV get into their sixties, they really have a double hit — from aging and from the effects of HIV.”

This is why Levin urges HIV-positive individuals to be screened for cardiovascular troubles as well as bone density, kidney disease, and cognitive impairment.

The scientific statement recommends trying the American Heart Association–American College of Cardiology Atherosclerotic Disease Risk Calculator as one way for getting some idea of your heart disease risk.

Overcoming Barriers to Treatment

Both Feinstein and Levin spotlight the need for improving access to healthcare for people living with HIV. The statement authors pointed out that this population is often stigmatized, and federal and local authorities could make more effort to increase care options for these individuals. Many living with HIV are homebound and cognitively impaired to a degree where they have difficulties paying bills and making decisions.

“What’s most needed are support services and better care in the clinics,” says Levin. “We need to actively demand that federal and local officials address this problem.”

He urges people to contact NATAP to explore ways to take action.

A Call for Further Research

Feinstein and his coauthors based this scientific statement on large observational studies investigating HIV and heart disease.

“But we don’t yet have much in the way of large-scale randomized trial data for heart disease prevention and treatment in HIV,” he says. “Although we have a reasonable understanding of why plaque buildup in the arteries occurs in HIV, we do not have as clear of an understanding of why the heart muscle often becomes dysfunctional or why blood clotting may occur more commonly in HIV.”

The post HIV and Early Heart Disease: Risks, Causes, and Prevention appeared first on MyMedicPlus.

During the Focusing on Fertility panel at the 137th Angus Annual Meeting, Kent Weigel, professor and chair of the Department of Animal and Dairy Sciences at the University of Wisconsin-Madison; Tom Lawlor, executive director of research and development at the Holstein Association, USA; and Kelli Retallick, director of genetic and genomic programs for Angus Genetics, Inc., discussed the importance of improving reproductive function for the Angus breed and the cattle industry and the role that haplotypes play in bovine fertility.

Haplotypes are alleles that are inherited as a group from a single parent. Through genomic testing, haplotypes that affect many traits can now be identified. In 2011, the dairy industry identified haplotypes that negatively affect fertility by causing embryonic loss. Using this research, AGI and the American Angus Association® have been studying haplotypes that affect fertility in the Angus breed.

Kent Weigel

Weigel began the discussion by addressing the importance of fertility and how research over the last 20 years has focused on improving fertility for the profitability of the operation. He provided the background and basic terminology surrounding haplotypes and highlighted their value in improving fertility.

Weigel shared how VanRaden and others identified five haplotypes that affect fertility in three breeds of dairy cattle in 2011. Researchers found that genomic testing provides shortcuts to finding lethal mutations that affect embryonic viability. Because embryos that inherit two copies of a lethal fertility haplotype from its parents are not carried to term, it is all about finding haplotypes with missing homozygotes.

“You can use a haplotype test many, many years in advance and they can provide a faster, albeit imperfect, way to manage potentially lethal defects more proactively,” said Weigel, as he concluded his presentation.

Tom Lawlor

Lawlor followed Weigel in the panel discussion where he focused on research that he has conducted at Holstein Association USA since 2011. The Holstein breed was one of the first to adopt genomic testing and discover haplotypes.

“The goal with genomic testing at the Holstein Association is to test and move our breed forward—NOT test and punish our association,” said Lawlor.

Lawlor shared how the Holstein breed turned haplotypes that impact fertility into a new class of genetic defects. He went into detail about the differences between genetic conditions and haplotypes. Fertility haplotypes tend have unseen problems; they occur before birth, have less of a financial loss and are less accurate.

Lawlor also stated, “We don’t want to simply eliminate families with these haplotypes and lose out on the genetic advantage they offer the breed.”

To properly manage fertility haplotypes, Lawlor shared how the Holstein Association has improved its communication and offered mating tools to help breeders more easily avoid carrier-to-carrier matings.

Kelli Retallick

Retallick concluded the panel as she shared what the Association is doing regarding haplotypes that affect fertility in Angus cattle. She emphasized how the Angus breed should learn from the dairy industry.

“When looking to the dairy industry, we learn that the Association needs an even larger database. These haplotypes affecting fertility occur at very low frequencies and genomic testing can help better manage haplotypes in herds,” said Retallick.

Retallick ended the Focusing on Fertility panel by addressing how haplotypes are a promising research endeavor. The AGI team knows that regions with missing homozygotes are present and that validating these regions would lead to additional opportunities to make genetic progress.

“As Angus breeders, you are uniquely positioned to leverage this type of research because of your dedication to growing the world’s largest single beef breed genomic database,” says Retallick.

Visit the American Angus Association YouTube channel, Angus TV, to watch the full Angus University webinar, Focusing on Fertility, and to subscribe for more educational content.

— Written by Whitney Whitaker, Angus Communications

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NEW YORK, Dec 25 — American researchers at the Mayo Clinic have identified a vaginal microbiota signature linked to endometrial cancer, which they believe to be partly promoted by postmenopause.

Endometrial cancer is detected when there is an abnormal proliferation of cells on the lining of the uterus. People who are obese, overweight, diabetic or post-menopausal are most at risk of developing this form of cancer.

As they are sensitive to these risk factors, the vaginal microbiota, i.e. all the microorganisms that populate the vagina, could play a role in screening for this cancer, particularly in post-menopausal women, say scientists at the Mayo Clinic in Rochester, United States, authors of a new research study published in Scientific Reports.

In 2017, this same team of researchers discovered differences in the uterine and vaginal microbiomes between patients with and without endometrial cancer in a uterine microbiome study, which was published in the review Genome Medicine.

Postmenopause is a key risk factor for endometrial cancer

This new research aims to understand the impact of patients’ risk factors (post-menopause and obesity) on the composition of vaginal microbiota. Based on the results obtained in the previous study, the researchers recruited women who had undergone a hysterectomy following endometrial cancer or a benign uterine condition at the Mayo Clinic.

Overall, the team reviewed and confirmed the major known risk factors for endometrial cancer (post-menopausal status and obesity) and identified high vaginal pH as an additional risk factor for endometrial cancer.

All these factors were found to impact the reproductive tract microbiome by increasing its diversity and reducing the dominance of lactobacilli species. The team also identifed postmenopause as a key factor of several microbiota associated with EC.

“We have determined that all of these factors impact the reproductive tract microbiome, further identified post menopause as a key factor, and are looking ahead to discuss potential translational applications of this knowledge, which may bring new approaches to address current health disparities in endometrial cancer,” said Dr Walther-Antonio, who led the study. — AFP-Relaxnews

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In days gone by, the woman or man who “had a little work done” on their face was easy to spot – the resulting tight-faced, permanently surprised look was a dead giveaway! But as with so many things in life, advances in technology and medicine bring improved experiences and results — and facelifts are no exception. The procedure is easier on the patient, and the results are natural and subtle, while still giving a more youthful appearance. To find out more about how facelifts have evolved over the years and the new technology behind them, we spoke with one of the country’s leading experts in the field, Dr. Phillip Langsdon of The Langsdon Clinic, who is also the 2018-19 President of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).

If the thought of paying lots of money only to end up with distorted features has you worried, you’re not alone. Although the number of cosmetic surgical procedures is on the rise (up 47% since 2013, according to an AAFPRS study), the fear of looking unnatural is the top concern among those considering a facelift, followed by worries about the cost and undergoing anesthesia, says Dr. Langsdon. But thanks to advances in the way procedures are done today, these worries can be alleviated.

Lose the “windblown” look.

Women today shy away from that super-tight, stiff face women in previous generations dealt with, and the more recent overly enhanced pouty trend favored by some celebrities is also shifting to a subtle, rejuvenated look. Luckily surgery techniques have evolved to make these shifts possible.

“A few decades ago, a facelift resulted in the ‘windblown’ look because the skin was indeed pulled and stretched very tightly,” Dr. Langsdon explains. “Today we reposition the muscles of the face. It is a gentler procedure that is much easier on the patient, and the outcome is refreshingly natural.”

Outpatient surgery means less expense.

You might be surprised at how affordable a facelift is. There’s no hospital stay; patients go home the same day. And the man or woman seeking cosmetic surgery here in Memphis or the Mid-South is in luck, as costs may be lower than in larger cities like New York City or Los Angeles.

“You’ll get as good or better results here,” says Dr. Langsdon. “They don’t know anything we don’t know.”

The anesthesia is easy.

The Langsdon Clinic uses the latest, state-of-the-art IV sedation, similar to that used for a colonoscopy. You go right to sleep and wake up quite refreshed when the surgery is over, with no lingering effects. “Our patients do not complain of pain after a facelift,” Dr. Langsdon adds.

When is a facelift right for you?

A facelift does not “lift” the whole face, nor does it erase wrinkles. Rather, it improves the visible signs of aging in the lower face, jowls, and upper neck, such as*:

• Sagging skin along the cheeks and jawline
• Deepened fold lines between the nose and mouth
• Jowls along the lower cheek and jaw
• Loose skin and/or excess fat of the neck, giving the appearance of a double chin or “turkey neck”

“A good facelift will remove years of sagging in a short period of time, and make it look natural. You can look better without people knowing why you look better,” says Dr. Langsdon. The best candidates are in reasonably good health and have realistic expectations of what surgery can do, he adds.

A facelift can be done in conjunction with other procedures as well. The Langsdon Clinic offers:

• Mid-facelifts, treating the upper cheeks
• Eyebrow lifts, to improve dropping eyebrows
• Eyelid surgery, to remove excess fat from upper and lower eyelids
• Brow lift, for the forehead and temples

When is a facelift right for you?

A facelift does not “lift” the whole face, nor does it erase wrinkles. Rather, it improves the visible signs of aging in the lower face, jowls, and upper neck, such as*:

• Sagging skin along the cheeks and jawline
• Deepened fold lines between the nose and mouth
• Jowls along the lower cheek and jaw
• Loose skin and/or excess fat of the neck, giving the appearance of a double chin or “turkey neck”

“A good facelift will remove years of sagging in a short period of time, and make it look natural. You can look better without people knowing why you look better,” says Dr. Langsdon. The best candidates are in reasonably good health and have realistic expectations of what surgery can do, he adds.

A facelift can be done in conjunction with other procedures as well. The Langsdon Clinic offers:

• Mid-facelifts, treating the upper cheeks
• Eyebrow lifts, to improve dropping eyebrows
• Eyelid surgery, to remove excess fat from upper and lower eyelids
• Brow lift, for the forehead and temples

It’s important to remember that a facelift or other facial procedure cannot add volume back in to your face. Fortunately, though, there are advanced techniques for that as well!

“We offer bio-compatible fillers for deflated areas of the face that we just didn’t have 35 years ago,” Dr. Langsdon offers. “We can do that in addition to the repositioning we do during a facelift.” Designed to improve smoothness as well as stimulate the natural production of collagen and elastin, the fillers are composed of a biosynthetic polymer, collagen, and hyaluronic acid.

Chemical peels have been around for a while and are very helpful for improving lines and wrinkles and minimizing pigment changes. A newer skin resurfacing tool is a laser treatment, which is a great complement to a peel. “It can do things a chemical peel can’t, such as provide tissue tightening, strengthen the skin, and improve elasticity,” explains Dr. Langsdon.

As with any medical procedure, if you are interested in a facelift or other procedure, seek the advice of a licensed professional who specializes in surgical procedures for the face. They can help you determine your best course of action. In the meantime, Dr. Langsdon offers up three common-sense tips to help your skin age gracefully:

• Don’t smoke.
• Stay out of the sun.
• Invest in good quality skin-care products.

The post Not Your Mother’s Facelift: How New Technology Makes Facelifts Look Natural appeared first on MyMedicPlus.

The American Nurses Foundation has awarded a $9,999 grant to Martha Grace Cromeens, a nurse at the University of North Carolina Hospital, to explore new pathways for diagnosing endometriosis among diverse groups of women.

The grant, supported by the Virginia Kelley Fund, will back Cromeens’ yearlong study, “Qualitative Inquiry into the Pathways to Diagnosis of Endometriosis Across a Diverse Sample of Women.” The study is expected to be concluded in August 2020.

Endometriosis can be a difficult-to-diagnose disease, often requiring invasive surgery to achieve a final diagnosis. For many women, that leads to years of struggling with chronic pelvic pain, menstrual irregularity, painful intercourse, and infertility, often without access to proper care.

In addition to its severe physical manifestations, endometriosis can represent a heavy economic burden for women and substantially diminish their quality of life. In many women, endometriosis significantly affects their work productivity, causes anxiety and depression, and results in high medical costs.

The scientific community has been working to find strategies that could prevent such delays in endometriosis diagnosis.

Cromeens, also a Hillman Scholar in Nursing Innovation, is joining this effort to better understand endometriosis and help all women affected by it.

She and her colleagues at the University of North Carolina will start by mapping the pathways for endometriosis diagnosis, according to a university press release. They will conduct qualitative interviews to acknowledge the experiences of women affected by the disorder, including detailed pathways for their symptom recognition, appraisal, and management.

Next, they will explore potential differences in these diagnosis pathways and experiences among a socioeconomically and racially diverse group of women.

As Cromeens noted in the project’s abstract, “women of lower socioeconomic status (SES) and minority races have been underrepresented in endometriosis research.”  Despite efforts made to overcome this problem, “there is a large gap in the literature regarding the diagnostic pathways women travel and the pre-diagnostic period especially among lower SES and non-white women.”

Cromeens also plans to determine what factors and symptoms are shared among women who perceive their endometriosis diagnosis as timely, and among those who have experience a delayed diagnosis.

This analysis may help better identify patterns of endometriosis symptoms and manifestations that could be useful for clinicians to expedite endometriosis diagnosis.

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A New York mother has become the third American woman to die in the last month after undergoing cosmetic surgery at a clinic in the Dominican Republic.

Alexandra Medina, 33, of New Rochelle, New York, underwent a tummy tuck at the Dr. Ureña Arias clinic in Santo Domingo on July 4. She later died of a pulmonary embolism, Noticias Sin reported.

Medina leaves behind a partner and a 14-year-old son, according to the New York Post.

Her death follows the deaths of two other Americans who underwent cosmetic surgeries at the same clinic.

Alabama woman Alicia Williams, 45, died on June 7, and 26-year-old Sharlim Paulino of New York died on June 20, according to El Nuevo Diario.

On a Facebook page Medina’s family page created, they said she flew to the Dominican Republic to have the same doctor perform her surgery as the other two victims.

But they allege that Dr. Félix Almánzar pulled out at the last minute and had another doctor take over because he was “scared” after the deaths of the two other patients.

Medina’s sister, Maxine David, told CBS New York that doctors in the US refused to perform the procedure unless she lost some weight first, but that Almánzar said it wasn’t an issue.

Her family said they warned her not to go through with the procedure after he asked for the full bill up front.

“They are criminals,” Medina’s mother, Kanny Toro, said in a videoposted on the Facebook page. “You don’t like your fat? Go to the gym. Workout. Sacrifice some food. Don’t do any body procedures on you because there’s always a risk … I urge you, I beg you, don’t do this.”

“It’s a dark lucrative business,” Toro added. “That’s all they want is money. They don’t care about lives.”

On Monday, officials in the Dominican Republic announced that the clinic had been closed while they investigate the deaths.

They said the clinic had only recently reopened after it was previously shuttered for suspected irregularities, Noticias Sin reported.

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