Age, HIV drugs and heart disease
Risk factors for heart disease include smoking, age (over 45 for men and over 55 for women), sex (male), lack of exercise, family history of heart disease, alcohol, high blood pressure and diabetes. Other risk factors associated with heart disease include raised levels of cholesterol and triglycerides, which can be a side effect of HIV treatment.
The largest study looking at heart disease and HIV treatment, reported an increased risk of heart disease related to some HIV drugs.
The most recent analysis linked this to the protease inhibitor Kaletra and to the nucleoside analogue abacavir.
It is important to know your underlying risk of heart disease if you are using either of these drugs.
Untreated HIV may be a risk. In the SMART study, people who stopped treatment were more likely to develop haert, kidney or liver disease than people on continuous treatment. The benefits of HIV treatment generally outweigh any additional risk of heart disease.
An assessment of cardiovascular and HIV risk factors is recommended for everyone when diagnosed, before starting HIV treatment and then annually.
Free risk assessment programmes are available on the internet:
- www.riskscore.org.uk (UK site with measurements in mmol/L)
- hp2010.nhlbihin.net/atpiii/calculator.asp (US site with measurements in mg/dL)
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.