"The leading cause of death and disease in HIV patients is no longer due to HIV but now other causes, in particular heart attack and strokes,” says Merle Myerson. "Even though our treatments of high cholesterol and blood pressure are good, the study results show there is much more for us to do to better control these heart disease risk factors in patients living with HIV." (Credit: Shutterstock)

Why are heart attacks killing people with HIV?

High blood pressure and high cholesterol are common for people with HIV but the conditions are often not well controlled, a new study finds.

“It is clearly important to add cardiology specialists to the care teams for patients with HIV,” says senior author Heejung Bang, professor of public health sciences at University of California, Davis. “We also need more research focused on identifying treatments that work in controlling heart disease and stroke risks for this patient population.”

For the study, published online in Journal of Acquired Immune Deficiency Syndromes, Bang and colleagues examined medical records for a diverse group of 4,278 outpatients in New York City ages 20-87 living with HIV who were treated at the Spencer Cox Center for Health, a designated New York state AIDS Center, located at Mount Sinai St. Luke’s and Mount Sinai Roosevelt hospitals.

The prevalence of high blood pressure and elevated cholesterol was high in the study population’s patients living with HIV: 35 percent of HIV patients had high LDL-cholesterol (also known as “bad” cholesterol) and 43 percent had hypertension.

While treatment rates were high for HIV patients with hypertension and/or high cholesterol, control of these risk factors was low. In the study, 90 percent of patients with high cholesterol were treated, but only 75 percent of those treated were at their goal cholesterol level. Also, 75 percent of HIV patients with hypertension were being treated, but only 57 percent were at their goal blood pressure.

Leading cause of HIV death

“The leading cause of death and disease in HIV patients is no longer due to HIV but now other causes, in particular heart attack and strokes,” says prevention specialist Merle Myerson, a physician and lead study author, who is director of the cardiology section at the Spencer Cox Center for Health at Mount Sinai St. Luke’s and Mount Sinai Roosevelt hospitals.

“Even though our treatments of high cholesterol and blood pressure are good, the study results show there is much more for us to do to better control these heart disease risk factors in patients living with HIV.”

Further research of HIV and cardiovascular disease is warranted, including research on how HIV treatments might complicate the control of cardiovascular disease risks. The new study, along with future studies, may provide a basis for developing guidelines for treating the growing population of HIV patients living with heart disease.

“Our findings highlight the need for more specific medical guidelines to aid in the prevention of cardiovascular disease in patients living with HIV and show that a comprehensive HIV clinic, which includes cardiovascular specialists, may be an important new standard of care,” Myerson says.

The Spencer Cox Center for Health at Mount Sinai supported the research.

Source: UC Davis

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