Living with HIV: Keeping your heart healthy

Living with HIV can increase your risk of heart disease, but there are things you can do to prevent this from happening. One of our world-leading cardiologists provides advice on how to best keep your heart healthy.

Higher risk of heart problems with HIV

The availability of highly effective treatments has dramatically increased the life expectancy in people living with HIV – an estimated 34.2 million people worldwide and over 100,000 people in the UK are living with HIV.  With successful care, all those living with HIV can now expect to achieve a near-normal lifespan.

As such, HIV is now increasingly considered as a chronic illness that can impact your cardiovascular health (the health of your heart and blood vessels). If you have HIV, your risk of a heart attack or stroke is increased by 1.5 to 2 times when compared to the general population, and established heart problems can also have frequent flair ups.

Initially, this increased risk to heart health was thought to be associated with taking antiretroviral medications. However, with the development of further research, it has gradually become clear that HIV triggers chronic inflammation of the inner lining of blood vessels which leads to their premature narrowing above and beyond the effect of traditional risk factors such as smoking, high cholesterol, diabetes and high blood pressure. This narrowing of blood vessels is a risk factor for heart disease.

Despite reports that some HIV medications are associated with metabolic abnormalities (such as increased cholesterol), it is important that you keep taking your medications regularly. Poorly controlled virus in your blood stream is likely to interact with your immune system in a way that accelerates a general inflammatory response and increases your risk of cardiovascular disease further.

How can I reduce my risk of heart disease?

Current traditional risk assessment scores are not able to assess your cardiovascular risk accurately. Therefore, the link between HIV and heart disease is an active area of research and studies are ongoing to determine how to best lower your risk.

One of the studies (the REPRIEVE trial) is assessing the effect of a cholesterol lowering drug called Pitavastatin in preventing heart attacks, strokes and claudication (pain caused by too little blood flowing to your arms and legs) due to narrowed blood vessels in around 8,000 people with HIV.

Those enrolled in the study have a low-to-moderate risk of cardiovascular disease by conventional measures, as people with HIV can experience cardiovascular disease even at these lower levels of risk. This study will provide doctors with handy tools for the treatment and prevention of heart disease specifically for people with HIV.

Whilst waiting for results from specific studies, there are many things you can do to help keep your heart and blood vessels healthy right now if you have HIV.

‘Sticking to your HIV treatment plan, maintaining normal weight by regular exercise – however gentle, and healthy eating together with the control of traditional risk factors are the best investments into future cardiac health.”

– Dr Aigul Baltabaeva, consultant cardiologist

‘If you are over 40, a regular well-person health check can help identify heart disease and other conditions, such as diabetes, sooner. We can then get you on a treatment plan and monitor your heart health to prevent the longer-term harm associated with these conditions.’

‘However, if you’re experiencing any symptoms that you are unsure about or have questions about your HIV treatment plan you should check in with your GP or HIV specialist sooner than your regular check-ups. We’re all here to help you live a healthy life.’