Risk factors for heart disease widespread among HIV patients

Keith Alcorn
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This article is more than 22 years old.

Risk factors for heart disease other than lipid elevations among people with HIV need close attention, according to an analysis of 394 patients at the Royal Free Hospital, London.

Cholesterol and triglyceride elevations after starting anti-HIV therapy have led some epidemiologists and clinicians to warn that an increasing incidence of heart disease may become apparent in a few year’s time among people with HIV.

Epidemiologists and doctors at the Royal Free Hospital reviewed risk factors among patients at the clinic. Forty-five per cent of the Royal Free cohort were smokers and 7% had an alcohol intake above the weekly recommended limit. 72% of current smokers had previously tried to stop.

Glossary

cholesterol

A waxy substance, mostly made by the body and used to produce steroid hormones. High levels can be associated with atherosclerosis. There are two main types of cholesterol: low-density lipoprotein (LDL) or ‘bad’ cholesterol (which may put people at risk for heart disease and other serious conditions), and high-density lipoprotein (HDL) or ‘good’ cholesterol (which helps get rid of LDL).

triglycerides

A blood fat (lipid). High levels are associated with atherosclerosis and are a risk factor for heart disease.

 

p-value

The result of a statistical test which tells us whether the results of a study are likely to be due to chance and would not be confirmed if the study was repeated. All p-values are between 0 and 1; the most reliable studies have p-values very close to 0. A p-value of 0.001 means that there is a 1 in 1000 probability that the results are due to chance and do not reflect a real difference. A p-value of 0.05 means there is a 1 in 20 probability that the results are due to chance. When a p-value is 0.05 or below, the result is considered to be ‘statistically significant’. Confidence intervals give similar information to p-values but are easier to interpret. 

lipid

Fat or fat-like substances found in the blood and body tissues. Lipids serve as building blocks for cells and as a source of energy for the body. Cholesterol and triglycerides are types of lipids.

hypertension

When blood pressure (the force of blood pushing against the arteries) is consistently too high. Raises the risk of heart disease, stroke, kidney failure, cognitive impairment, sight problems and erectile dysfunction.

  • 20% had a BMI >26kg/m2 (associated with a higher risk of cardiovascular disease)

  • 34% were aged over 40

  • 29% reported a family history of heart disease

  • 14% had hypertension

  • 18% had total cholesterol > 6.3mmol/l

  • 36% had non-fasting triglycerides > 2.3mmol/l

  • 10% had HDL cholesterol

Among patients on HAART (73% of the cohort), raised cholesterol and triglyceride levels were significantly more common, as was a family history of heart disease (38% vs 30%, p=0.03).

However, patients on HAART were significantly less likely to smoke (43% vs 47%, p=0.03); it appeared that those who were ex-smokers (24% of the cohort) were more likely to have given up after starting HAART (65% of ex-smokers). The Royal Free Hospital offers smoking cessation courses for HIV-positive patients as part of its HIV clinic service.

References

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.

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