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


  1. Smith C et al. Cardiovascular disease risk factors and antiretroviral therapy in an HIV-positive UK population. Sixth International Congress on Drug Therapy in HIV Infection, Glasgow, abstract P162, 2002
  2. Mulligan K et al. Obesity and dyslipidemia in behaviourally HIV-infected young women: Adolescents Trials Network Study 021. Clin Infect Dis 50: 106-14, 2010
  3. George E et al. Kidney function and the risk of cardiovascular events in HIV-1-infected patients. AIDS 24: 387-94, 2010
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.