HIV (human immunodeficiency virus) has long been known for its impact on the immune system, but recent research reveals another serious health challenge: increased cardiovascular risk. A groundbreaking global study highlights that individuals living with HIV face a 1.5–2 times greater likelihood of developing cardiovascular diseases (CVD) such as heart attacks and strokes compared to the general population.
This revelation underscores the importance of addressing heart health as a priority in HIV care. Despite advances in antiretroviral therapy (ART) that have improved life expectancy, the risks associated with heart disease in HIV patients are often overlooked. This blog will explore the study’s findings, the reasons behind these risks, and actionable steps to manage and mitigate them.
Key Findings of the Global Study
The comprehensive study analyzed data from a diverse range of populations worldwide, focusing on the prevalence of cardiovascular disease among people living with HIV. The results challenge conventional risk assessment models and reveal gaps in healthcare approaches for this vulnerable group.
The study found that people with HIV are significantly more likely to experience heart disease, strokes, and related complications than those without the virus. Traditional risk assessment tools fail to account for HIV-specific factors such as chronic inflammation and ART side effects. While antiretroviral therapy extends life expectancy, it can contribute to metabolic changes that increase cardiovascular risk.
Why Are HIV Patients at Greater Risk?
The heightened cardiovascular risk stems from a combination of biological, medical, and lifestyle factors unique to people living with HIV.
HIV causes persistent, low-level inflammation as the body continuously battles the virus. Over time, this inflammation damages blood vessels and accelerates the buildup of arterial plaque, a key driver of heart disease. Even when ART suppresses the virus to undetectable levels, the immune system often remains in a state of overactivity, further exacerbating vascular damage.
Reference: How HIV Vaccines Could Spark Antibodies Against Antibodies
While ART is essential for managing HIV, some drugs can contribute to cardiovascular issues. Certain ART regimens increase levels of “bad” cholesterol (LDL) and triglycerides, promoting atherosclerosis. Additionally, ART may disrupt glucose metabolism, leading to insulin resistance and an elevated risk of type 2 diabetes. ART-related lipodystrophy can also result in abnormal fat accumulation, particularly in the abdomen, which is linked to heart disease.
Socioeconomic factors, stigma, and mental health challenges often affect the lifestyle choices of people with HIV, increasing their cardiovascular risks. Smoking rates tend to be higher among those living with HIV, amplifying CVD risk. Financial constraints and limited access to healthy foods can lead to unhealthy dietary habits. Drug and alcohol use, often higher in certain HIV populations, further strains heart health.
As ART allows people with HIV to live longer, age-related cardiovascular risks become more pronounced. Ageing alone is a significant factor in heart disease, and its effects are compounded by HIV-related inflammation and metabolic changes.
Limitations of Traditional Risk Assessment Models
Standard cardiovascular risk calculators, such as the Framingham Risk Score, are inadequate for predicting heart disease in HIV patients. These tools focus on conventional factors like cholesterol levels, age, and smoking, but fail to account for the unique contributions of chronic inflammation and ART-related metabolic changes.
This gap highlights the need for HIV-specific cardiovascular risk models to better guide healthcare providers in preventing and managing heart disease in this population.
Recognizing Cardiovascular Warning Signs
Early detection is critical in preventing severe cardiovascular events. People living with HIV should watch for symptoms such as unexplained discomfort or tightness in the chest, difficulty breathing during everyday activities, persistent tiredness without apparent cause, fluid buildup in the legs or feet, and episodes of lightheadedness. These warning signs may indicate cardiovascular problems that require immediate medical attention.
Preventive Measures for HIV Patients
Managing cardiovascular risk is crucial for improving long-term health outcomes for individuals with HIV. Regular cardiovascular checkups, including cholesterol tests, blood pressure monitoring, and glucose level assessments, should be integrated into HIV care plans. Early detection allows for timely interventions.
Adopting a heart-healthy lifestyle is essential for reducing cardiovascular risk. A balanced diet with fruits, vegetables, whole grains, and lean proteins should be prioritized while minimizing processed and sugary foods. Regular physical activity, such as walking or swimming, for at least 150 minutes per week, can significantly benefit heart health. Quitting smoking and limiting alcohol consumption are also key steps in improving cardiovascular health.
Patients and healthcare providers should work together to evaluate ART regimens and consider switching to newer, less cardiotoxic medications if necessary.
Addressing stress, anxiety, and depression through counselling or support groups can improve overall well-being and reduce the burden on the cardiovascular system.
The Role of Healthcare Systems
Healthcare systems must evolve to address the cardiovascular risks associated with HIV. Developing and implementing guidelines tailored to the unique cardiovascular challenges of HIV patients will ensure more effective care. Healthcare providers should receive training on the intersection of HIV and heart health to better recognize and address these risks. Raising awareness about the cardiovascular risks faced by HIV patients can encourage proactive screening and healthier lifestyle choices.
Future Directions in Research
The study’s findings call for continued research into the links between HIV and cardiovascular disease. Promising areas of exploration include anti-inflammatory therapies that target chronic inflammation to reduce vascular damage, next-generation ART drugs with fewer cardiovascular side effects, and personalized medicine tailored to individual risk profiles based on genetic and molecular insights.
Conclusion
The global study sheds light on the underappreciated cardiovascular risks faced by people living with HIV. As healthcare advances continue to improve life expectancy, addressing heart health must become a priority in HIV care. Through proactive screening, lifestyle changes, medication optimization, and systemic healthcare improvements, we can help people with HIV live longer, healthier lives.
Together, we can bridge the gap in care and ensure that no aspect of HIV-related health is overlooked.
Reference: Cardiovascular risk underestimated for people with HIV
