Cardiovascular Disease and HIV

Cardiovascular disease or heart disease is by no means limited to the HIV+ community. In fact, heart disease is the number 1 killer of men and women in the United States. However, in recent years, there has been an increasing number of reports of heart disease or heart attacks among relatively healthy men with HIV. The actual cause of this increase in heart conditions among men with HIV has not been determined, but a number of factors have been identified as possible causes, including:

• Long-term HIV infection


• Increased cholesterol levels among people on Highly Active Antiretroviral Therapy or HAART


• An increase in common heart disease factors among people with HIV, such as age, cigarette smoking, diabetes, and family history of heart disease

Whatever the cause, if you are HIV+ or HIV-, there are a number of things you can do to decrease your risk of heart disease or heart attack.

Reducing Your Risk of Heart Disease or Heart Attack It is always a good time to think about what you can do to reduce your chances of having a heart attack or developing heart disease. The key to making your heart healthier is to keep your blood pressure low and monitor your cholesterol and blood fat levels. Here is a list of ideas that you should review and discuss with your healthcare provider:

• Know your cholesterol number—HIV medications, specifically some protease inhibitors or PIs, have been shown to increase cholesterol levels in the body. HIV infection can also increase your blood fat levels. Does this mean you should stop taking your HIV medication? Absolutely not! If you are HIV+, you and your healthcare provider should check your cholesterol and blood fat levels every 6 to 12 months. If your cholesterol and blood fat levels are high, there are things that your healthcare provider can do to help


• Butt out—quitting smoking is one of the best things you can do to decrease your chances of having a heart attack or developing heart disease. Talk to your healthcare provider about things that can help you quit, including support groups, nicotine patches, nicotine gum, and prescription medications


• Watch what you eat—the National Institutes of Health recommends eating foods low in saturated fats and avoiding foods high in cholesterol. For more information about these diet suggestions, check out the patient/general public section at: www.nhlbi.nih.gov/about/ncep/index.htm. Most importantly, talk to your healthcare provider before making any decisions concerning your diet


• Watch your weight—losing weight can lower your cholesterol and blood fat levels. However, if you are suffering from wasting, losing weight may not be an option. So, if you need to put on weight but your cholesterol or blood fat levels are high, try eating foods high in unsaturated fats rather than eating foods high in saturated fats. Talk to your healthcare provider about the food choices you make


• Get physical—exercise can help lower your cholesterol levels and blood pressure. Aerobics or even walking 30 minutes a day can help get your cholesterol and blood pressure back on track. Lifting weights is great for building muscle and putting on weight, but you should know that weight lifting does not help lower cholesterol or high blood pressure


• Additional medication—the best way to keep your heart healthy is through diet, exercise, and lifestyle changes, but this is not always enough. If you and your healthcare provider decide you need to do more, there are drugs that can help lower your blood pressure as well as your cholesterol and fat levels. However, some of these drugs may interfere with your HIV medications. So, be sure to talk to your healthcare provider about your options


• Changing your HIV medications—some HIV medications may increase your cholesterol. Talk with your healthcare provider about your HIV treatment options