HIV and Increased Risk for Heart Attack
HIV and Heart Attack (Courtesy Medlineplus.gov)
By Matt Olszewski
HIV and the chronic inflammation it causes, paired with a diminished immune system, can result in unwanted cardiovascular complications in patients. Specifically, individuals living with HIV are at a notably higher risk for heart attack than those without HIV. However, even though there is no cure for HIV, treatments such as antiretroviral therapy can help.
With a high number of HIV cases worldwide, especially in areas where effective prevention techniques are not in place, the risk for myocardial complications has remained prominent. More specifically, HIV patients are at a heightened risk for myocardial infarction (heart attack). Primary prevention of cardiovascular disease and effective control of risk factors can help support this vulnerable population. At the end of 2022, 39.0 million people were living with HIV worldwide, an increase from 31.5 million people in 2010.
HIV weakens the immune system by targeting and destroying CD4+ T-cells, which is crucial for mounting an effective immune response. As a result, people with HIV are more susceptible to various infections and may experience chronic inflammation and an increased risk of heart attack. Here are some important details on the health effects of HIV and how to mitigate the risk for cardiovascular conditions, especially heart attacks.
What is HIV
HIV (human immunodeficiency virus) originated from chimpanzees in Central Africa and gradually developed and spread worldwide. HIV attacks the immune system–specifically T cell lymphocytes and CD4 cells. It can be fatal if left untreated; however, there are many treatment options despite no cure. If you suspect you may have HIV, you can get tested. Those diagnosed with HIV can still live healthy lives with an appropriate treatment regimen.
How does HIV increase the risk for heart attack?
HIV patients are at a higher risk for cardiovascular diseases, including heart disease and cardiomyopathy. Notably, those with HIV are at an increased risk for myocardial infarction. This can be due to other health conditions exacerbating that risk. These conditions include diabetes, hypertension (high blood pressure), and cardiovascular disease. These can lead to several of the following mechanisms increasing heart attack risk:
Atherosclerosis: Hypertension and diabetes can cause damage to the inner lining of blood vessels (endothelium) and lead to the accumulation of cholesterol and other substances in the artery walls. This buildup forms plaques that narrow the arteries and reduce blood flow to the heart muscle.
Coronary artery disease (CAD): Atherosclerosis can progress over time, leading to the narrowing and hardening of the coronary arteries, which supply oxygen and nutrients to the heart muscle. As these arteries become increasingly narrowed, it becomes more difficult for the heart to receive the required blood flow, leading to a condition known as coronary artery disease.
Endothelial dysfunction: Both hypertension and diabetes can impair the endothelium’s ability to regulate blood vessel dilation and constriction properly. This dysfunction can contribute to further atherosclerosis and an increased risk of blood clot formation, which may lead to heart attacks.
Increased stress on the heart: Hypertension strains the heart as it needs to pump blood against a higher resistance in the blood vessels. Over time, this can cause the heart muscle to thicken and become less efficient at pumping blood, leading to a high risk of heart failure.
What is antiretroviral therapy, and how can it help HIV patients?
Antiretroviral therapy (ART) uses a combination of drugs to reduce the replicability of HIV. Thus, with advances in antiretroviral therapy, treating and managing HIV has significantly improved. When HIV is well-controlled with ART, the immune system is better supported, reducing the risk of opportunistic infections and associated complications, including heart attack. However, the virus persists and is produced at low levels even after ART. Hence, patients are still at high risk for cardiovascular health conditions even with treatment, so paying close attention to health biomarkers is crucial.
How can HIV patients adapt their lifestyle to reduce the risk of heart attack?
By controlling blood pressure and blood sugar levels, adopting a heart-healthy diet, engaging in regular exercise, and avoiding smoking and excessive alcohol consumption, the risk of heart attacks can be significantly reduced. If you have either of these conditions, working closely with your healthcare provider to develop a comprehensive management plan to protect your heart health is crucial.
If you or someone you know is living with HIV, working closely with healthcare professionals and monitoring cardiovascular health is beneficial. Following a comprehensive care plan that includes regular check-ups, screenings, and adherence to ART can help minimize the risk of potential complications. As research continues, our understanding of the interplay between HIV and myocarditis will evolve, so staying informed with the latest medical information is essential.
About the Author
Matt Olszewski is a freelance writer in the Health and Medical fields based in Boston, MA. He graduated with a BA in Psychology and has work experience in clinical research. Bilingual in English and Spanish, he is currently studying at Tufts University for his MPH with a biostatistics and epidemiology concentration. During his free time, he loves going on runs, hikes, and exploring new cities.
