HIV infection appears to increases the risk of heart attack

Researchers from Massachusetts General Hospital (MGH) have found that infection with HIV, the virus that causes AIDS, is also associated with increased risk of myocardial infarction or heart attack. While rates of several cardiovascular risk factors were also increased in study participants infected with HIV, the increased incidence of heart attack was beyond what could be explained by risk factor differences. The report will be published in the Journal of Clinical Endocrinology and Metabolism and has been released online.

"Our study shows a higher incidence of myocardial infarction and major cardiovascular risk factors in HIV-infected patients, compared with noninfected patients," says Steven Grinspoon, MD, of the MGH Program in Nutritional Metabolism and Neuroendocrine Unit, the report's senior author. "Those findings indicate that those infected with HIV should be assessed for cardiovascular risk factors and that we urgently need to develop strategies to modify those risks."

It has been recognized that many HIV-infected individuals have metabolic abnormalities – including altered levels of blood lipids such as cholesterol, insulin resistance, type 2 diabetes, and changes in fat distribution in the body. Researchers have reported that patients taking antiretroviral medications may have increased risk of heart attacks, but few studies have directly examined whether HIV-infected patients in general have more heart attacks than non-infected individuals do.

The researchers took advantage of the Research Patient Data Registry, a database of demographic and diagnostic information on more than 1.7 million patients treated at MGH and Brigham and Women's Hospital since 1993. They compared information on almost 4,000 HIV-infected patients with data from more than one million patients without HIV. Study participants were aged 18 to 84 and were seen at least twice during the study period of almost eight years. Any patient whose initial visit was for a heart attack was excluded from the study group.

Across all age groups included, the risk of myocardial infarction occurring after the initial hospital visit was markedly higher for those infected with HIV. Although traditional cardiovascular risk factors – such as elevated lipid levels, diabetes and hypertension – also were more common among the HIV-infected patients and did account for some increased risk, the increased risk for heart attack associated with HIV remained significant even when adjusted for those risk factors. Overall, the risk of heart attack was almost doubled in all those with HIV and was almost tripled among women.

"Followup studies are needed to better determine why myocardial infarction rates are higher in HIV patients, which risk factors drive this risk most, and how smoking – which we weren't able to completely evaluate in this study – affects this risk," Grinspoon says. "We also need to analyze the relationship of antiretroviral medications to cardiovascular risk. HIV medications save lives, and patients should continue taking them as prescribed; but we want physicians to be aware of these increased heart attack rates, watch risk factors carefully and appropriately target their treatment." Grinspoon is an associate professor of Medicine at Harvard Medical School.

Source: Massachusetts General Hospital

Related stories:

3 share Nobel prize for work on AIDS and cancer
(AP) -- Three European scientists shared the 2008 Nobel Prize in medicine on Monday for separate discoveries of viruses that cause AIDS and cervical cancer, breakthroughs that helped doctors fight the deadly diseases.
HIV drug maraviroc effective for drug-resistant patients
As many as one quarter of HIV patients have drug resistance, limiting their treatment options and raising their risk for AIDS and death. Now, maraviroc, the first of a new class of HIV drugs called CCR5 receptor antagonists, has been shown to be effective over 48 weeks for drug-resistant patients with R5 HIV-1, a variation of the virus found in more than half of HIV-infected patients.
As personalized, genomic medicine takes off, four developing countries show the way for others
Developing countries that want the benefits of cutting-edge health care possibilities based on the genetic variation of individual citizens and sub-populations need to foster the new science at home, says a major new Canadian study published today by Nature Publishing Group.
An 'HIV-test' equivalent for the early detection of lung cancer
A team of researchers led by Fred Hutchinson Cancer Research Center reports online today in the Journal of Clinical Oncology the validation of a potential "HIV-test" equivalent for the early detection of lung cancer. The test, which relies on immune-system signals, much like an HIV test, can detect the presence of lung cancer a year prior to diagnosis, long before symptoms appear.
Tuberculosis drug shows promise against latent bacteria
A new study has shown that an investigational drug (R207910, currently in clinical trials against multi-drug resistant tuberculosis strains) is quite effective at killing latent bacteria. This revelation suggests that R207910 may lead to improved and shortened treatments for this globally prevalent disease.
HIV patients at greater risk for bone fractures
HIV-infected patients have a higher prevalence of fractures than non HIV-infected patients, across both genders and critical fracture sites according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
'Nutraceuticals' could prevent diabetes
People at high risk for developing type 2 diabetes might be able to delay or prevent the disease by taking certain food supplements and making lifestyle changes, according to a new book by Dr. James W. Anderson, an internationally recognized authority on metabolic diseases and weight loss and professor emeritus of medicine and clinical nutrition at the University of Kentucky College of Medicine.
Women in India abused by husbands at far greater risk for HIV infection
India is home to the third-largest number of human immunodeficiency virus (HIV) cases in the world and, as in the U.S. and many African nations, the rate of infection among women continues to rise faster than that among men. In a new study, researchers at the Harvard School of Public Health (HSPH) have found that married Indian women who experienced physical and sexual abuse at the hands of their husbands were approximately four times more likely to become infected with HIV than married women who were not abused. This first large-scale, national study to examine the relationship between intimate partner violence (IPV) against wives and clinically verified HIV infection appears in the August 13, 2008 issue of JAMA.

News discussion:

Medicine & Health news