If You Have HIV, You Are More Likely to Suffer a Heart Attack

Cardiovascular disease is the number one killer of both men and women in the United States, according to the Centers for Disease Control and Prevention, killing one in four Americans every year. But for people living with HIV, the risk is quadrupled.  

As Dr. Paul M. Ridker from Harvard Medical School told New York Times, the most likely explanation for the increased risk in HIV-positive people is that both the virus and the drugs that fight it cause chronic inflammation, which causes the liver to make more cholesterol (another heart attack risk factor). 

Heart health should always be a concern as we get older. While studies have shown that antiretroviral therapy may increase heart disease risk, studies such as the Strategies for Management of Antiretroviral Therapy also found more heart attacks in people who delayed or stopped treatment when compared to those who remained on therapy. So which is it?

People living with HIV often neglect to worry about their hearts because they’ve spent all their focus worrying about the virus. The truth is HIV-positive people are living long and health lives just like everybody else. They must consider health concerns that come with aging, including matters of the heart, regardless of their viral load. 

“The likelihood of dying of HIV is low, but the likelihood of dying from a Myocardial Infarction (heart attack) is high,” Dr. Frank Spinelli, Associate Clinical Professor of Medicine at NY Medical College, says to Plus. “If you’re 55 and your father had a heart attack, we need to worry about heart disease with you. You have to take it from a personalized level: eat right, exercise, and don’t smoke. There’s a higher prevalence of smoking among HIV-positive people. We have to manage patients as if they’re going to live the rest of their lives just like you would anyone else.”

Whether you have a suppressed viral load or not, the duration of HIV is one of the strongest predictors of heart attack, reports AIDS Map. High cholesterol and blocked arteries are now becoming highly recognized as something health professionals should discuss with patients living with HIV. Because of this, it’s important to take necessary steps.

What is a heart attack?

According to Heart.org, a heart attack occurs when a blocked artery prevents oxygen-rich blood from reaching a section of the heart. The blocked artery needs to be reopened very quickly, otherwise the heart will not be nourished and will begin to die.

What are the warning signs of a heart attack?

The American Heart Association says that while heart attacks are sudden, most start slowly with mild pain and discomfort:

Discomfort in the center of your chest lasting longer than a few minutes, or that goes away and comes back — pressure, squeezing, fullness or pain.

Discomfort in other areas of the upper body, including one or both arms, the back, neck, jaw or stomach.

Shortness of breath, with or without chest discomfort.

Breaking out in a cold sweat, nausea, or lightheadedness.

What is cardiac arrest?

It often occurs without warning, and is triggered by an electrical malfunction in the heart that causes an irregular heartbeat, i.e.. arrhythmia. Heart.org says if the heart doesn’t pump blood to the brain or other organs, a process that is disrupted by cardiac arrest, a person will lose consciousness and will not have a pulse. Death can occur within minutes without immediate treatment.

What are the warning signs of cardiac arrest?

A new study in the Annals of Internal Medicine showed many cardiac arrest patients experienced warning signs days or weeks before, yet most of them had ignored them. According to researchers, over half of patients experienced intermittent chest pain and pressure, shortness of breath, palpitations, or ongoing flu-like symptoms such as nausea and abdominal and back pain.

What can HIV-positive people do to help prevent heart disease?

Make better lifestyle choices as it pertains to diet, exercise and smoking. While a healthy diet and regular exercise have an overwhelming impact on cardiovascular health, smoking has the largest negative impact on blood pressure and a hardening of the arteries (atherosclerosis), which is already slightly jeopardized.

Always check your cholesterol and triglyceride levels. High levels increase the risk of heart problems. Some doctors will recommend a change in your antiretroviral treatment or other drugs that will help reduce the levels.

Try and control your blood pressure by easing the stress in your life. Obviously, a better diet and more exercise will help make this a reachable goal.