March 6, 2013
The risk of heart attack goes up almost 50 percent for HIV-infected people, even when other risk factors are considered, according to University of Pittsburgh School of Medicine researcher Dr. Matthew Freiberg. The increased risk probably results from the combination of the HIV virus's effects and antiretroviral therapy (ART).
ART has extended life expectancy for HIV-infected people, so researchers are now exploring health threats facing HIV-infected people as they age. The current study analyzed six years of data from more than 82,000 US veterans, a third of whom were HIV-infected. Of the 871 study participants who had a heart attack, HIV-infected participants were 48 percent more likely to have a heart attack than vets ages 40 to 69 who did not have HIV. The study controlled for other factors -- high blood pressure, diabetes, and drug and alcohol use -- also associated with higher heart attack risk.
Since past studies show that HIV increases the risk of heart disease, Freiberg theorized that the presence of the virus stimulates an "inflammatory response" that increases heart attack risk. Hepatitis C and kidney disease also are associated with increased risk of heart attack. University College of Dublin School of Medical Science's Dr. Patrick Mallon stated that the veterans' study clears up questions about whether HIV and HIV medications increase heart attack risk or other factors like smoking and high cholesterol are responsible for higher risk.
Mallon and Freiberg recommended that HIV-infected people make lifestyle changes such as quitting smoking and take preventive measures, including regular blood pressure and cholesterol checks, to prevent heart attack.
The full report, "HIV Infection and the Risk of Acute Myocardial Infarction," was published online in the journal JAMA Internal Medicine (2013; doi:10.1001/jamainternmed.2013.3728).