Cardiovascular risk factors among people with HIV

Risk factors for heart disease in the general population include:

• Older age.
• Sex (men are more at risk than women).
• A family history of heart disease.
• A previous personal history of heart disease.
• Smoking.
• High alcohol consumption.
• Lack of exercise.
• High blood pressure.
• High LDL and total cholesterol levels.
• Low HDL cholesterol levels.
• Diabetes or insulin resistance.
• Being overweight.

Many of these risk factors are widespread among people with HIV, regardless of any influence of antiretroviral therapy or HIV infection. In 2002, epidemiologists and doctors at the Royal Free Hospital in London found the following risk factors among HIV-positive patients at the clinic:

• 45% were smokers.
• 7% had an alcohol intake above the weekly recommended limit.
• 20% had a body mass index (BMI) above 26, a level associated with a higher risk of cardiovascular disease.
• 34% were aged over 40.
• 29% reported a family history of heart disease.
• 14% had high blood pressure.
• 18% had total cholesterol above 6.3mm.
• 36% had non-fasting triglycerides above 2.3mm.
• 10% had high density lipoprotein (HDL) cholesterol below 0.9mm.

High cholesterol and triglyceride levels, and family history of heart disease, were significantly more common among patients on highly active antiretroviral therapy (73% of the cohort). ¹ Multiple risk factors have also been identified in other cohorts.²

One retrospective study in people with HIV has also found impaired kidney function to be a risk factor for cardiovascular disease in people with HIV.³