Increased Risk for Heart Disease and Stroke for People Living with HIV

People living with HIV are at increased risk of developing cardiovascular conditions, according to a study published in the Journal of the American Heart Association.^1-3 A large health insurance database was used as the source for data collection in a study that looked at nearly 20,000 people living with HIV (PLWH) and nearly 60,000 people matched on age and sex from 2009–2015.

The findings were consistent: a reported 1.5 to 2 times increase in the rate of cardiovascular events in persons living with HIV compared with the control population.^1-2,4 And notably, PLWH were also at 3.2-times higher risk of heart failure and a 2.7-times higher risk of stroke.^2-3

The role of antiretroviral therapy

Antiretroviral therapy (ART) has been essential to HIV treatment, helping people to live longer lives. It has been effective in reducing the overall number of HIV-related deaths. Before 1996, the mortality (number of deaths) among those living with HIV was over 20%.

With the advancement of effective treatment, the number of deaths decreased to less than 2 percent. Currently, more people living with HIV now pass away from non-AIDS-related causes than AIDS-related causes.^2,4

Cardiovascular disease and HIV

While evaluating the causes of death for the study population, concerns were identified about cardiovascular disease (CVD). The findings indicated that CVD, particularly heart failure and stroke, has emerged as a significant cause of death in people who are HIV positive. This is significant, especially when compared to the decreasing incidence of opportunistic infections.⁴

The importance of heart education and prevention

Investigators report the importance of health education and primary prevention and how both can play a role in the looking at cardiovascular risk factors.³ The general population is aware that high blood pressure and smoking are not good for general health. But the study's authors suggest that people living with HIV are at increased cardiovascular risk. Preventive education around awareness could help people in this subset of the population reduce their risk for heart disease.

Heart disease in people under age 50

The report also found that the association between HIV and CVD was notable in people younger than 50 years old, and those without a prior family history of cardiovascular disease.³ Cardiac damage due to HIV infection and HIV medications has resulted in an increased risk of developing heart failure in younger people.

Why is this important?

This is significant because there may be an opportunity for risk reduction through informed behavioral change. This increased risk in persons younger than 50 years old is also significant due to aging: as we age there are an increasing number of competing causes for developing heart failure.^2-3

More research on heart disease

The specific reasons why people living with HIV are at increased risk for developing certain heart conditions are not known.² More research is needed to validate the results of this study. These increased research efforts can assist in providing direction and information that will help recognize, prevent, and treat cardiovascular conditions in people living with HIV.^2-3