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(Reuters Health) – People living with HIV are more likely to have heart disease than those who are not infected with the virus. That's why it's even more critical to exercise, eat well and avoid smoking, according to American doctors.
In recent decades, antiretroviral therapy has turned the human immunodeficiency virus (HIV) from a near-death sentence into a chronic, manageable disease. Because HIV-positive patients live longer, they also have a higher risk of heart attack, stroke, heart failure, sudden cardiac death, and other illnesses than non-HIV-infected people. according to a scientific statement issued by the American Heart Association (AHA) in circulation.
"Even when the virus is controlled so that it is not detectable by routine blood tests, it remains in some body tissues a reservoir of HIV that causes chronic activation of the immune system and the Inflammation, "said Dr. Matthew Feinstein of Northwestern University Feinberg. Chicago School of Medicine, lead author of the statement.
"This chronic immune activation and inflammation can, over time, lead to plaque build-up in the arteries of the heart and blood vessels, and even blood clotting and problems with the heart muscle itself," he said. Feinstein by email. This results in … more heart attacks, strokes and heart failure due to problems related to the heart muscle's ability to contract and / or relax. "
In the United States, three out of four people living with HIV are now over the age of 45 and face various health problems at an earlier age than those who are not affected, the statement said.
To complicate matters, people living with HIV may also be more likely to have some risk factors for heart disease, such as smoking and poor nutrition. About 42% of people living with HIV smoke, for example.
Other risk factors for heart disease that are more common among HIV-positive people include alcohol abuse, substance abuse, mood disorders, and anxiety.
According to the statement, many people living with HIV are facing stigma and difficulties in accessing and caring for them. Barriers can include poverty, inadequate health insurance, limited education, depression, social isolation as well as discrimination based on gender identity, badual orientation, race or ethnicity.
Although these barriers are a problem even in the absence of HIV, the risk of heart disease badociated with HIV makes it critical to change risk factors under the control of patients, the doctors said.
"As HIV has become a chronic disease, addressing issues that may worsen, including higher rates of cardiovascular disease, is an important part of comprehensive HIV care," said Dr. Paul Volberding, Director AIDS research. Institute of the University of California at San Francisco.
"It is important for clinicians to badess these risks and collaborate with the patient to avoid poor outcomes by changing lifestyle and, in some cases, performing medical interventions," said Volberding, not involved in the statement. "The main modifiable risks are smoking, lack of regular exercise, obesity and high levels of blood lipids."
To badess their cardiovascular risk, people with HIV or not can start with a free online tool, according to the statement. One option is an AHA calculator and American College of Cardiology that estimates the risk of a person over 10 years of events such as a heart attack or accident cerebrovascular (https://bit.ly/20iCydu).
However, the calculation indicates that people living with HIV may be at a higher risk than the calculator, because of unique risk factors, such as the long wait for antiretroviral therapy after HIV diagnosis.
To keep people living with HIV healthy, Feinstein stresses the importance of a healthy lifestyle that includes quitting smoking, adequate physical activity, eliminating or reducing alcohol consumption. and a healthy diet. In addition, patients should take all medications necessary to maintain healthy blood pressure and cholesterol levels.
SOURCE: https://bit.ly/2wB6CvB Circulation, online June 3, 2019.
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