Age, HIV drugs and heart disease
The biggest risks for heart disease are smoking, poor diet and low exercise.
- Other factors include age (over 45 for men and over 55 for women), sex (male), family history of heart disease, alcohol, high blood pressure and diabetes.
- High cholesterol (and sometimes triglycerides) are independent risks. They are also related to diet and exercise.
- As some HIV drugs can cause cholesterol and triglycerids to increase you will be monitored for this.
- HIV itself may be a risk for heart disease if you are not on treatment.
In the SMART study, people who stopped treatment were more likely to develop heart, kidney or liver disease than people on continuous treatment. This study showed that the benefits of HIV treatment generally outweigh any additional risk of heart disease.
The largest study looking at heart disease and HIV treatment (called D:A:D), has shown that most HIV meds are not linked to heart disease.
There are two exceptions though: the protease inhibitor lopinavir/r (Kaletra) and the nucleoside abacavir.
It is important to know your underlying risk of heart disease if you use either of these drugs.
Checking your risks of heart disease is recommended when you are first diagnosed, before starting HIV treatment and then every year after.
Online risk calculators
http://www.chip.dk/TOOLS/tabid/282/Default.aspx
As in the general population, making lifestyle changes to reduce your risk of heart disease is good advice if you are HIV positive.
This becomes even more important if you have other risk factors as these add up to a higher overall risk.