{"id":24,"date":"2025-06-24T08:41:36","date_gmt":"2025-06-24T03:11:36","guid":{"rendered":"http:\/\/www.mymedicplus.com\/news\/?p=24"},"modified":"2025-06-24T08:41:37","modified_gmt":"2025-06-24T03:11:37","slug":"hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association","status":"publish","type":"post","link":"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/","title":{"rendered":"HIV and Early Heart Disease: Risks, Causes, and Prevention"},"content":{"rendered":"\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_81 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%F0%9F%A7%AC_Introduction\" >\ud83e\uddec Introduction<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%F0%9F%94%AC_Why_Does_HIV_Increase_Heart_Disease_Risk\" >\ud83d\udd2c Why Does HIV Increase Heart Disease Risk?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#1_Chronic_Inflammation_Immune_Activation\" >1. Chronic Inflammation &amp; Immune Activation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#2_Immune_System_Dysfunction\" >2. Immune System Dysfunction<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#3_Side_Effects_of_Antiretroviral_Therapy_ART\" >3. Side Effects of Antiretroviral Therapy (ART)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#4_Higher_Prevalence_of_Traditional_Risk_Factors_in_PLWH\" >4. Higher Prevalence of Traditional Risk Factors in PLWH<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#5_HIV-Associated_Lipodystrophy\" >5. HIV-Associated Lipodystrophy<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%F0%9F%A9%BA_What_Does_the_Research_Say\" >\ud83e\ude7a What Does the Research Say?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%E2%9D%A4%EF%B8%8F_Early_Warning_Signs_Screening\" >\u2764\ufe0f Early Warning Signs &amp; Screening<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#Doctors_typically_monitor\" >Doctors typically monitor:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%F0%9F%9B%A1%EF%B8%8F_Prevention_Strategies_How_to_Lower_the_Risk\" >\ud83d\udee1\ufe0f Prevention Strategies: How to Lower the Risk<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%E2%9C%85_1_Stick_to_Effective_ART\" >\u2705 1. Stick to Effective ART<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%E2%9C%85_2_Adopt_Heart-Healthy_Habits\" >\u2705 2. Adopt Heart-Healthy Habits<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%E2%9C%85_3_Control_Blood_Pressure_Cholesterol\" >\u2705 3. Control Blood Pressure &amp; Cholesterol<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%E2%9C%85_4_Manage_Diabetes_and_Insulin_Resistance\" >\u2705 4. Manage Diabetes and Insulin Resistance<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%E2%9C%85_5_Address_Mental_Health_Stress\" >\u2705 5. Address Mental Health &amp; Stress<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%F0%9F%A7%A0_Summary_Table_HIV_and_Heart_Disease\" >\ud83e\udde0 Summary Table: HIV and Heart Disease<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#%F0%9F%93%8C_Final_Thoughts\" >\ud83d\udccc Final Thoughts<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#Addressing_Common_Heart_Disease_Factors\" >Addressing Common Heart Disease Factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#Living_Longer_But_With_More_Health_Problems\" >Living Longer But With More Health Problems<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#Overcoming_Barriers_to_Treatment\" >Overcoming Barriers to Treatment<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/www.mymedicplus.com\/blog\/hiv-patients-face-higher-risk-of-early-heart-disease-and-obstacles-to-care-says-american-heart-association\/#A_Call_for_Further_Research\" >A Call for Further Research<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%F0%9F%A7%AC_Introduction\"><\/span>\ud83e\uddec Introduction<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>With the success of antiretroviral therapy (ART), <strong>people living with HIV (PLWH)<\/strong> now enjoy longer life expectancies than ever before. However, this increased lifespan has brought a <strong>new challenge<\/strong>: a significantly <strong>higher risk of early cardiovascular disease (CVD)<\/strong>.<\/p>\n\n\n\n<p>Research shows that <strong>HIV-positive individuals are 1.5 to 2 times more likely<\/strong> to develop heart disease at a younger age compared to HIV-negative individuals. This article explores the underlying causes, scientific findings, and most importantly, <strong>how to reduce that risk through prevention and lifestyle changes<\/strong>.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%F0%9F%94%AC_Why_Does_HIV_Increase_Heart_Disease_Risk\"><\/span>\ud83d\udd2c Why Does HIV Increase Heart Disease Risk?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Cardiovascular disease in HIV patients is <strong>multifactorial<\/strong>, meaning it&#8217;s influenced by a mix of biological, lifestyle, and treatment-related factors.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"1_Chronic_Inflammation_Immune_Activation\"><\/span>1. <strong>Chronic Inflammation &amp; Immune Activation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Even with effective ART and undetectable viral load, <strong>HIV causes persistent low-grade inflammation<\/strong> in the body. This leads to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Damage to <strong>blood vessel linings (endothelium)<\/strong><\/li>\n\n\n\n<li>Increased <strong>plaque formation<\/strong><\/li>\n\n\n\n<li>Accelerated <strong>atherosclerosis<\/strong> (hardening of arteries)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"2_Immune_System_Dysfunction\"><\/span>2. <strong>Immune System Dysfunction<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>HIV affects <strong>CD4+ T-cells<\/strong>, weakening the immune system. This dysfunction can:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Promote <strong>autoimmune reactions<\/strong><\/li>\n\n\n\n<li>Make the body less effective at repairing vascular damage<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"3_Side_Effects_of_Antiretroviral_Therapy_ART\"><\/span>3. <strong>Side Effects of Antiretroviral Therapy (ART)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Some older or specific ART drugs (especially <strong>protease inhibitors<\/strong> and <strong>abacavir<\/strong>) are associated with:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Increased <strong>cholesterol and triglyceride levels<\/strong><\/li>\n\n\n\n<li><strong>Insulin resistance<\/strong><\/li>\n\n\n\n<li>Elevated <strong>risk of metabolic syndrome<\/strong><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"4_Higher_Prevalence_of_Traditional_Risk_Factors_in_PLWH\"><\/span>4. <strong>Higher Prevalence of Traditional Risk Factors in PLWH<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>People living with HIV often have a higher rate of:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Smoking<\/strong><\/li>\n\n\n\n<li><strong>Diabetes<\/strong><\/li>\n\n\n\n<li><strong>Obesity<\/strong><\/li>\n\n\n\n<li><strong>Sedentary lifestyle<\/strong><\/li>\n\n\n\n<li><strong>Co-infections<\/strong> like Hepatitis B\/C, which can indirectly impact cardiovascular health<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"5_HIV-Associated_Lipodystrophy\"><\/span>5. <strong>HIV-Associated Lipodystrophy<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>This condition, caused by some ART medications, leads to abnormal fat distribution and metabolic changes, further increasing the risk of heart disease.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%F0%9F%A9%BA_What_Does_the_Research_Say\"><\/span>\ud83e\ude7a What Does the Research Say?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Several key studies have demonstrated the link between HIV and heart disease:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The REPRIEVE Trial (NIH, ongoing)<\/strong> is investigating whether statins can prevent heart disease in HIV patients.<\/li>\n\n\n\n<li>A study published in <em>JAMA Cardiology<\/em> (2020) found that <strong>HIV-positive individuals had a 50\u2013100% higher risk<\/strong> of heart attack than the general population.<\/li>\n\n\n\n<li>A 2023 report in <em>The Lancet HIV<\/em> showed <strong>increased arterial stiffness and vascular inflammation<\/strong> in young adults with HIV \u2014 even those on effective ART.<\/li>\n<\/ul>\n\n\n\n<p>In short, <strong>heart disease now rivals opportunistic infections<\/strong> as a leading cause of morbidity in aging HIV patients.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%9D%A4%EF%B8%8F_Early_Warning_Signs_Screening\"><\/span>\u2764\ufe0f Early Warning Signs &amp; Screening<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p><strong>HIV patients often experience &#8220;silent&#8221; heart disease<\/strong>, where symptoms may not be obvious until major events like a heart attack or stroke occur. Regular screening is essential.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Doctors_typically_monitor\"><\/span>Doctors typically monitor:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Blood pressure<\/strong><\/li>\n\n\n\n<li><strong>LDL\/HDL cholesterol<\/strong><\/li>\n\n\n\n<li><strong>Blood sugar and insulin levels<\/strong><\/li>\n\n\n\n<li><strong>C-reactive protein (CRP)<\/strong> \u2014 marker of inflammation<\/li>\n\n\n\n<li><strong>Carotid intima-media thickness (CIMT)<\/strong> \u2014 ultrasound measure of artery wall thickening<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%F0%9F%9B%A1%EF%B8%8F_Prevention_Strategies_How_to_Lower_the_Risk\"><\/span>\ud83d\udee1\ufe0f Prevention Strategies: How to Lower the Risk<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Fortunately, many of the risks can be <strong>controlled with the right interventions<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%9C%85_1_Stick_to_Effective_ART\"><\/span>\u2705 1. <strong>Stick to Effective ART<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Modern ART regimens are <strong>safer and more heart-friendly<\/strong> than earlier generations.<\/li>\n\n\n\n<li>Staying virally suppressed <strong>reduces inflammation and immune activation<\/strong>.<\/li>\n\n\n\n<li>If you&#8217;re on older ART (e.g., abacavir, lopinavir), talk to your doctor about switching.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%9C%85_2_Adopt_Heart-Healthy_Habits\"><\/span>\u2705 2. <strong>Adopt Heart-Healthy Habits<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Lifestyle Change<\/th><th>Why It Helps<\/th><\/tr><\/thead><tbody><tr><td>Quit smoking<\/td><td>Smoking triples heart risk in HIV patients<\/td><\/tr><tr><td>Regular exercise<\/td><td>Improves blood flow, lowers inflammation<\/td><\/tr><tr><td>Balanced diet<\/td><td>Emphasize whole foods, fruits, and omega-3s<\/td><\/tr><tr><td>Limit alcohol<\/td><td>Excess alcohol contributes to hypertension<\/td><\/tr><tr><td>Maintain healthy weight<\/td><td>Reduces blood pressure and blood sugar<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%9C%85_3_Control_Blood_Pressure_Cholesterol\"><\/span>\u2705 3. <strong>Control Blood Pressure &amp; Cholesterol<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Use <strong>statins<\/strong> if needed \u2014 they not only lower cholesterol but also have <strong>anti-inflammatory benefits<\/strong> in HIV.<\/li>\n\n\n\n<li><strong>REPRIEVE trial<\/strong> is evaluating long-term statin use in HIV for prevention even in low-risk patients.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%9C%85_4_Manage_Diabetes_and_Insulin_Resistance\"><\/span>\u2705 4. <strong>Manage Diabetes and Insulin Resistance<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Monitor <strong>A1C<\/strong> and fasting glucose regularly.<\/li>\n\n\n\n<li>Adopt a <strong>low-glycemic index<\/strong> diet and stay active.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%9C%85_5_Address_Mental_Health_Stress\"><\/span>\u2705 5. <strong>Address Mental Health &amp; Stress<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Chronic stress and depression (common in HIV) can raise cortisol and BP.<\/li>\n\n\n\n<li>Practice <strong>mindfulness, therapy, and sleep hygiene<\/strong>.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%F0%9F%A7%A0_Summary_Table_HIV_and_Heart_Disease\"><\/span>\ud83e\udde0 Summary Table: HIV and Heart Disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Risk Factor<\/th><th>Effect on Heart<\/th><\/tr><\/thead><tbody><tr><td>Chronic inflammation<\/td><td>Damages arteries, causes plaque buildup<\/td><\/tr><tr><td>ART side effects<\/td><td>Can raise cholesterol and sugar levels<\/td><\/tr><tr><td>Lifestyle (e.g., smoking)<\/td><td>Amplifies risk of heart attack<\/td><\/tr><tr><td>Aging with HIV<\/td><td>Accelerates atherosclerosis<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%F0%9F%93%8C_Final_Thoughts\"><\/span>\ud83d\udccc Final Thoughts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>People living with HIV now live longer \u2014 but with longevity comes <strong>greater vulnerability to chronic illnesses<\/strong> like heart disease. The good news is that with <strong>early screening<\/strong>, <strong>modern ART<\/strong>, and <strong>healthy lifestyle choices<\/strong>, heart disease in HIV-positive individuals is <strong>largely preventable<\/strong>.<\/p>\n\n\n\n<p>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,&nbsp;according&nbsp;to the American Heart Association (AHA).<\/p>\n\n\n\n<p>A scientific statement published in June 2019 in the journal <em>Circulation<\/em> 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\u2019t have HIV.<\/p>\n\n\n\n<p>\u201cChronic inflammation and immune activation [or response] appear to be the primary drivers of high heart disease risk in HIV,\u201d 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.<\/p>\n\n\n\n<p>He stresses that HIV treatment  is essential,&nbsp;not only for controlling the virus, but also for reducing  chronic inflammation and problems with immune regulation.<\/p>\n\n\n\n<p>\u201cSeveral  studies have now shown that worse HIV control is associated with higher  risks for heart disease,\u201d Dr. Feinstein told Everyday Health. \u201cSo 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.\u201d<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Addressing_Common_Heart_Disease_Factors\"><\/span>Addressing Common Heart Disease Factors<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p>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.<\/p>\n\n\n\n<p>About 4 out of 10 are smokers, according to a nationally representative sample of HIV patients.<\/p>\n\n\n\n<p>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.<\/p>\n\n\n\n<p>Sarah Samaan, MD,  a cardiologist with Baylor Scott &amp; 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&nbsp;blood pressure.<\/p>\n\n\n\n<p>\u201cSince\n some HIV medications can raise the risk of side effects from other \ndrugs, it\u2019s important to discuss the options for treatment with a \nknowledgeable physician,\u201d say Dr.&nbsp;Samaan. \u201cA good pharmacist can also \nhelp to ensure that the drugs that are prescribed are safe and \nappropriate.\u201d<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Living_Longer_But_With_More_Health_Problems\"><\/span>Living Longer But With More Health Problems<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p>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.<\/p>\n\n\n\n<p>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.<\/p>\n\n\n\n<p>\u201cMost\n people don\u2019t know that HIV is causing accelerated aging,\u201d says Levin, \nwho has been living with HIV for 35 years. \u201cWithin a few years of \ninitial infection, the immune system senescence [deterioration with age]\n sets in right away. Once people with HIV get into their sixties, they \nreally have a double hit \u2014 from aging and from the effects of HIV.\u201d<\/p>\n\n\n\n<p>This\n is why Levin urges HIV-positive individuals to be screened for \ncardiovascular troubles as well as bone density, kidney disease, and \ncognitive impairment.<\/p>\n\n\n\n<p>The scientific statement recommends trying the American Heart Association\u2013American College of Cardiology Atherosclerotic Disease Risk Calculator as one way for getting some idea of your heart disease risk.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Overcoming_Barriers_to_Treatment\"><\/span>Overcoming Barriers to Treatment<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p>Both\n Feinstein and Levin spotlight the need for improving access to \nhealthcare for people living with HIV. The statement authors pointed out\n that this population is often stigmatized, and federal and local \nauthorities could make more effort to increase care options for these \nindividuals. Many living with HIV are homebound and cognitively impaired\n to a degree where they have difficulties paying bills and making \ndecisions.<\/p>\n\n\n\n<p>\u201cWhat\u2019s most needed are support services and better \ncare in the clinics,\u201d says Levin. \u201cWe need to actively demand that \nfederal and local officials address this problem.\u201d<\/p>\n\n\n\n<p>He urges people to contact NATAP to explore ways to take action.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Call_for_Further_Research\"><\/span>A Call for Further Research<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p>Feinstein and his coauthors based this scientific statement on large observational studies investigating HIV and heart disease.<\/p>\n\n\n\n<p>\u201cBut\n we don\u2019t yet have much in the way of large-scale randomized trial data \nfor heart disease prevention and treatment in HIV,\u201d he says. \u201cAlthough \nwe have a reasonable understanding of why plaque buildup in the arteries\n occurs in HIV, we do not have as clear of an understanding of why the \nheart muscle often becomes dysfunctional or why blood clotting may occur\n more commonly in HIV.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\ud83e\uddec Introduction With the success of antiretroviral therapy (ART), people living with HIV (PLWH) now enjoy longer life expectancies than [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":25,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[87,88,85,84,52,86,55],"class_list":["post-24","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aids-hiv","tag-american","tag-association","tag-disease","tag-heart","tag-hiv","tag-obstacles","tag-patients"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - 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