Hyperlipidemia and HIV/AIDS: High Cholesterol and Triglycerides

Table of Contents

• Introduction
• Hyperlipidemia and HIV
• How to Know if you Have Hyperlipidemia
• Foods That Affect Cholesterol and Triglyceride Levels
• Exercise and Hyperlipidemia
• Drugs for Hyperlipidemia
• HIV Drugs and Hyperlipidemia
• Other Risks for Heart Disease
• Taking Care of Yourself

Introduction

Lipids are fats and fat-like substances in the blood. Cholesterol and triglycerides are lipids. Your body uses cholesterol to build and maintain cells and to make some hormones. After eating, energy that is not needed right away is converted into triglycerides, which is stored in fat cells.

While having some cholesterol and triglycerides in the blood is important for the body to function properly, having too much is unhealthy. Having high levels of lipids is called hyperlipidemia.

Hyperlipidemia and HIV

There are many possible causes for high lipid levels, including HIV and some of the HIV drugs. This puts HIV+ people at particular risk for developing hyperlipidemia. Although you cannot tell if you have this condition without lab tests, it can cause serious long-term health problems.

The main danger of hyperlipidemia is heart disease. If you have too much cholesterol in your blood it can build up in your arteries (blood vessels), forming plaque. This buildup of plaque can lead to a heart attack or a stroke. High triglycerides can also increase your risk of getting pancreatitis (a painful inflammation of the pancreas).

Some HIV+ people experience lipodystrophy. Lipodystrophy includes hyperlipidemia, as well as other unwanted changes in body fat and blood sugar levels. These changes have been linked with diabetes, heart disease, and strokes. (For more info, see TWP sheets on lipodystrophy).

How to Know if you Have Hyperlipidemia

There are two main kinds of cholesterol. One is low-density lipoproteins (LDL) or "bad" cholesterol, which can clog the arteries. The higher your LDL, the higher your risk of heart disease. The other is high-density lipoproteins (HDL) or "good" cholesterol, which can help reduce the risk of heart disease.

Your health care provider can tell you if you have high cholesterol or triglycerides by doing a simple blood test called a fasting lipid profile. This will measure total cholesterol, HDL, LDL, and triglycerides. (You should have nothing to eat or drink for 8-12 hours before the test is done.) The following levels are ideal:

• Total cholesterol -- less than 200
• Low-density lipoproteins (LDL) -- less than 100
• High-density lipoproteins (HDL) -- 60 or higher
• Triglycerides -- less than 150

Foods That Affect Cholesterol and Triglyceride Levels

There are several types of fat found in the foods we eat including saturated, polyunsaturated, and monounsaturated. Saturated fat raises cholesterol the most. It is considered "bad" fat. Polyunsaturated and monounsaturated fats tend to keep cholesterol low and are considered to be "good" fats.

Saturated fat is usually solid at room temperature. It is found in the fat of animal products like meats and dairy. It is also found in a few vegetable products like coconut, palm, and palm kernel oil. To keep saturated fat low, check the label and choose dairy products with low saturated fat like skim or 1 percent milk, tub spreads, and low fat cheese and ice cream. When you are buying meats, choose cuts called "loin" or "round" -- these are the leanest.

Polyunsaturated and monounsaturated fats ("good" fats) include oils, mayonnaise, nuts and avocados. If you use oil in cooking, the two best choices are canola and olive oil.

Eating a lot of "refined" carbohydrates -- sugary foods, soda, and white bread can raise triglycerides. If you need to reduce total cholesterol, LDL, and triglyceride levels it is important to limit the amount of bad fats and excess sugar in your diet. See a registered dietitian to help you make good choices and plan your meals. Many AIDS service organizations have registered dietitians on staff who will see you free of charge. (For more info, see TWP sheet on nutrition).

Exercise and Hyperlipidemia

Aerobic, or cardiovascular exercise, is the kind of exercise that will help lower your lipid levels. It has been found to lower total cholesterol, triglycerides, and LDL and can raise HDL!

Aerobic exercises include fast walking, jogging, swimming, bicycling, and stair climbing. Try to work out at least three times a week for 20-30 minutes.