HIV and Heart Disease: What is the Link?
HIV is a big deal for your heart health. Without proper care, you are twice as likely to have a heart attack or stroke if you have HIV. That risk goes up even more if you don’t take your antiretroviral therapy (ART) every day.
HIV and heart disease aren’t such a long shot as you imagine. Even if you don’t have medical problems (like high blood pressure or diabetes) and keep your viral load low with ART, the odds of a heart attack are still 1.5 times higher than someone who doesn’t have HIV and is the same age as you.

HIV and Heart Disease: The Statistics
Rates of HIV-associated heart disease are rising, especially among younger people. It’s important to understand the risk factors, so you can be proactive about prevention.
Every year, more than 1.2 million people in the United States are diagnosed with HIV. In addition to other complications such as cancer, depression and dementia, people who have HIV are at increased risk for heart disease.
HIV-associated heart disease is on the rise across the country, especially among young people. A study published in 2009 in the journal AIDS and Behavior showed that since 2004, there has been a 31 percent increase in deaths due to HIV-related cardiovascular disease among those younger than 50 years old.
Although only 0.5 percent of Americans have HIV or AIDS, the risk is higher if you’re an injection drug user or a gay man.
And because some symptoms of heart disease mimic those of other illnesses common among this population — including fatigue, shortness of breath and night sweats — it’s important to know how to recognize heart disease if you’re living with HIV or AIDS so you can seek treatment early if necessary.
Why HIV increases the Likelihood of Cardiac Disease
If you want to lower your risk of heart disease and live a longer life, then you’re going to need to take care of yourself. And that means paying attention to your HIV status.
HIV is a virus that attacks the immune system. If left untreated, HIV can cause AIDS, which weakens the immune system and leaves someone more vulnerable to diseases.
Current statistics show that people with HIV have a higher chance of developing heart disease than those who do not have HIV.

HIV and Heart disease

As many as 25 percent of people with HIV are expected to develop heart disease, while only 4 percent of people without HIV will develop this type of condition. This is unfortunate since heart disease is one of the leading causes of death in American adults over the age of 35.

One reason why people with HIV are more likely to develop heart disease is because they take antiretroviral medication, or ARVs for short. These medications can cause side effects such as dehydration and electrolyte abnormalities, which can lead to heart problems.

Additional factors for HIV and Heart disease may include smoking or drug use among people with HIV. This places their hearts at the risk of developing health problems due to chronic stress on the body.
Understanding Heart Disease
Heart disease is one of the most widespread chronic illnesses and one of the leading causes of death in the world. It is a general term that covers many different diseases and conditions. Some cause no symptoms; others lead to chest pain, shortness of breath, dizziness, or fainting.
Heart disease can be caused by a number of factors, including smoking, high blood pressure, unhealthy cholesterol levels, diabetes, obesity, and physical inactivity.
Some common heart diseases include:

  • Coronary artery disease – when plaque builds up in the arteries that supply blood to the heart, which leads to a heart attack;
  • Heart failure – when the heart muscle weakens and cannot pump blood as effectively;
  • Stroke – when a clot blocks or ruptures a blood vessel in the brain, causing bleeding or cell death;
  • Congestive heart failure – a condition where the heart is no longer able to pump enough blood into circulation.

The good news is that many risk factors for heart disease can be controlled or changed.

HIV and Heart Disease: What Does HIV do to the Heart?

HIV affects your heart in two ways:

  • through your immune system
  • and by damaging your blood vessels.

Your immune system protects you against infections. It also helps keep your arteries clear of plaque, a thick, sticky substance that can lead to heart disease. When you have HIV, the virus can make it hard for your immune system to do its job right.

And if you don’t take HIV medicines to treat your infection and control it, things get even worse. So you’re more likely to:

  • get a bacterial or viral infection (such as pneumonia)
  • have an illness related to inflammation (such as arthritis)
  • have depression.

Taking HIV medicines can help keep your immune system working well and lower your risk of infections, inflammation and depression. But it won’t protect you from heart disease itself, because HIV damages blood vessels directly.
HIV and Heart Disease: How Much is the Risk?
The risk of heart disease for those living with HIV is not the same for everyone. The following factors can increase your risk for heart attack or stroke:

  • Having an undetectable viral load and taking ART, but still being at significant risk of heart disease.
  • Taking certain medications such as protease inhibitors (PIs)
  • Having diabetes, high blood pressure, or high cholesterol
  • Smoking cigarettes

Treating HIV infection doesn’t protect people from developing heart disease or having a stroke or heart attack. If you have HIV, you need to take steps to reduce your risk of developing heart problems by taking medicine to lower cholesterol and blood pressure, losing weight if necessary, and stopping smoking.

How to Prevent HIV-associated Heart Disease
Heart disease is a serious condition that can lead to death. HIV does increase the risk for heart disease and some other health conditions for a variety of reasons. Fortunately, you can decrease your risk by following a few simple steps.
1. Eat healthy
The first step in preventing heart disease is to eat healthy. Maintain a balanced diet and avoid any foods that increase heart disease risks.
2. Get enough sleep
If you have HIV, it is very important to get plenty of rest every night. Getting enough sleep every night can help lower heart disease risk.
3. Exercise
Exercise will help you lower your stress levels and allow you to maintain healthy blood pressure levels. Stress can also be a factor in increasing the risk of heart attacks.
4. Quit Smoking
You should also avoid smoking because this increases the risk to your cardiovascular system. Smoking causes the blood vessels in your body to narrow and restricts blood flow, which leads to high blood pressure, as well as an increased risk of heart disease.
5. Keep a healthy weight
Maintaining a healthy weight is also very important because being overweight or obese increases the risk of heart disease significantly.
6. Cut down on alcohol
The last thing that you should do is quit drinking alcohol altogether. It is true that alcohol damages the liver and causes fatty deposits in the arteries, but moderate alcohol consumption may actually have protective effects against cardiovascular disease.
Moderate alcohol consumption means one drink per day for women and two drinks per day for men.
Managing HIV-associated Heart Disease
Treatment for HIV and heart disease is improving all the time, so it’s important to talk to your doctor about any cardiac-related symptoms you have — even if they aren’t serious right now.
Here are some things to keep in mind:

  • HIV often causes inflammation and damage to blood vessels, which can lead to heart disease.
  • HIV treatment can also cause problems with cholesterol levels, blood pressure and other factors that increase the risk for heart disease.
  • Statins are the standard treatment for high cholesterol levels. These medications can help prevent heart attacks if you have HIV and high cholesterol levels.

If you’re living with HIV and have high blood pressure or diabetes, your doctor will work with you to keep your blood pressure low and blood sugar under control. This is important because it has been shown that treating these conditions in people with HIV reduces their risk of heart attack and stroke.

Studies have also shown that using antiretroviral therapy (ART) along with certain medications called statins can reduce your risk of developing heart disease by as much as 30 percent in people who are not taking ART.

You should talk to your doctor about whether statin therapy is right for you. Statins work by lowering cholesterol levels so they can help prevent heart attacks and stroke, but they do not cure the underlying cause of these diseases or reverse the damage.
Last Advice on HIV and Heart Disease.
Visiting your doctor regularly, eating a diet rich in nutrients, exercising, avoiding tobacco and alcohol, and living an active social life are some of the ways to reduce the risk of heart disease if you have HIV.