Im writing to ask if you can offer any advice on my situation. Ive been diagnosed with high cholesterol. On your American scale, it is 231.6 (thats 6 here in the UK). In Feb 16, it was 212.3 (5.5 here) and in Aug 16 (5.3) it was just slightly lower at 204.5. In each case the actual ratio (total cholesterol/hdl-c) has risen from 5.9 to 6.3 to 7.2.
My blood pressure is also creeping up. Over the years this has always been good but over the last few months Ive noticed it just edging into the pre-hypertension mode. Today it is 131/86.
Im a 52 year old man, diagnosed in 2010 with a low CD4 (86) and high VL. I was originally treated with Atripla and Truvada. In 2014 I moved onto Dolutegravir and Truvada. My CD4 is now around the 650 mark and viral load is undetectable.
In terms of risk, Im not aware of any family members having cardiovascular problems before 60, though my father and his brother both died of abdominal aortic aneurysms early in life (at 52 and 66). At least one grandparent died of stroke.
I lead a healthy life. I exercise 5 times a week in high intensity classes. I avoid saturated fats and mainly eat fish and vegetables. I dont drink during the week and at weekends I only really have a couple of glasses of wine on a Friday and Saturday night. I suppose I could be a little stricter. I have the odd cake at a weekend. Despite all this my weight is creeping up too. Im 5 ft 6 in. Im now 74 kg up from 69 a couple of years ago. I regularly feel lethargic, lack energy, and dont get fantastic erections either, despite having quite a high sex drive.
I feel like Im heading for the cardiovascular problems which seem prevalent in the ageing HIV community, despite my healthy life style. Aside from going onto a water and steamed veg diet, I dont see what I can do to improve my cholesterol or energise myself! What advice could you give me? Do you think I could have other issues going on? I am always terribly bloated, but they put it down to IBS.
Your situation and concerns bring up numerous important topics. Hopefully you are not a smoker, have a good blood pressure, and are not a diabetic (all of those risk factors deserve attention if present). You may want to discuss the use of a statin to further lower your cholesterol (LDL focus) and low dose aspirin with your HIV provider. There is some data (and a large study underway called the Reprieve Study) suggesting benefit for using potent statins among HIV+ persons. You might also want to ask your HIV provider to run several cardiovascular disease risk calculations (Framingham, DAD, VACS) to estimate your 10 year cardiovascular risk score and the potential benefit of additional interventions. KH