HIV and Cardiovascular Disease (Heart Disease)

Why are HIV patients at higher risk for CVD?

Having HIV places you at a higher risk for cardiovascular disease. Whether due to long-term exposure to the HIV virus or to antiretroviral agents or because of other factors, people living with HIV often share some common issues that affect cardiovascular health, including:
Higher triglyceride levels
An elevation in triglyceride levels is common among HIV-positive individuals. High triglycerides as well as too much bad cholesterol can increase a person's likelihood for artery problems.
Not enough good cholesterol
Many people living with HIV have lower levels of HDL (or good cholesterol).
Chronic Inflammation
There is evidence that people living with HIV often have chronic inflammation of the arteries and veins, perhaps from therapies or as a result of long-term exposure to the virus. Inflamed arteries are more likely to signal the body to send in additional infection-fighting white blood cells, or t-cells, which may be in short supply due to the HIV. Also, inflamed arteries trap more plaque.
Smoking
60-70% of people living with HIV still smoke cigarettes, compared to roughly 20% of the adult HIV-negative population. Learn more about smoking and heart disease.
Atherosclerosis
All the above factors increase the risk for atherosclerosis, which can place added strain on the heart.
Kidney failure
Although research is continuing on this topic, it is becoming clear that people living with HIV have higher risks for kidney disease. Your kidneys are very important to your cardiovascular health, partly because they help stablize blood pressure. Kidneys also filter your body fluids and get rid of waste. However, the HIV virus can damage the tubules, or filters, in the kidneys. There is also evidence that some antiretroviral medications can damage the kidneys, however kidney failure is more common among those not taking antitretrovirals than those who are. About 30% of HIV-positive individuals have protein in the urine, which can signal problems with the reabsorption in the tubules.
Diabetes
Recent studies about diabetes risks for those with HIV contain some conflicting data, but it is clear that minimizing your risks for diabetes is important. Diabetes contributes to heart disease and stroke, so you and your doctor will want to track your glucose numbers during your routine care.

It's also important to note that HIV patients are living longer, and the risk for heart disease increases for both HIV-positive and HIV-negative people as they age. For this reason, everyone needs to be aware of cardiovascular risks and wellness strategies.