If You're HIV-Positive You Must Take Your Statins

A new report published in the Journal of Acquired Immune Deficiency Syndromes shows a majority of HIV-positive people at high risk for heart disease are not on statins, a lipid-lowering medication that’s been found to reduce heart disease particularly in the early stages. 

Researchers studied cases at a clinic in Chicago, and found that only one-third of people who were eligible to be on statin therapy were using it for preventative measures. Thankfully, however, the majority of people who were already diagnosed with clinical heart disease and/or diabetes were taking statins. 

Needless to say, these results are frightening, especially since studies have shown that HIV-positive people are more likely to suffer a heart attack. Even if one's viral load is undetectable, HIV-positive are still at risk. 

So why aren’t doctors recommending for HIV-positive people to be on statin therapy? Good question... 

HIV is not mentioned as a consideration in the 2013 edition of the American College of Cardiology/American Heart Association for assessing cardiovascular disease risk and use of lipid-lowering medications as prevention, AIDS Map points out.

According to the Centers for Disease Control and Prevention, cardiovascular disease is the number one killer of both men and women, killing 25 percent of Americans every year. But for poz people, that risk is four to six times higher. 

In fact, HIV poses the same risk of heart disease as diabetes. Findings published in the journal Clinical Infectious Diseases show that the increased inflammation one gets from having HIV creates metabolic changes. And as a result, people are likely to have low levels of “good” HDL cholesterol, which contribute to heart disease. 

“Though we acknowledge that current cardiovascular guidelines have not been validated for the HIV-positive population, this study highlights potentially suboptimal cardiovascular disease prevention and management among HIV-positive [people],” authors from the Chicago study wrote. 

Currently, there is limited data on the use of statins among HIV-positive people at high risk for heart disease, which is why investigators from the Infectious Diseases Center at Northwestern University designed the initial study, reports AIDS Map. 

In the study, researchers took 460 patients (81 percent male with a median age of 52), and assessed risk factors. On the bases of the 2013 ACC/AHA guidelines, only 194 patients were eligible for statins — yet only 95 of them were on treatment. 

“Available evidence strongly supports statin use in HIV+ patients,” the researchers state. “HIV-positive persons are exceptionally vulnerable to [heart disease] compared to the general population due to an increased burden of high-risk, non-calcified plaque and higher prevalence of [heart disease] risk factors.”

In order for the call of action to be made to update the 2013 ACC/AHA guidelines to broaden the use among HIV-positive people, further studies are needed to figure out the best strategies of exactly how to do it. Researchers write, “The growing evidence of increased CVD risk in HIV+ patients, likely even higher than predicted by the ACC/AHA guidelines, underscores the need for corrective measures.”