The Increasing Global Burden of HIV-Associated Heart Disease

A CVS study has just revealed that HIV infection doubles the risk of heart disease. Additionally, the study showed that the global burden of HIV-associated cardiovascular disease has tripled in the past 20 years, and most greatly affects those in sub-Saharan Africa and Asia-Pacific regions.

Disability adjusted life years per 100,000 persons by country

By reviewing global data from 153 countries, the CVS research team examined the association between HIV and cardiovascular disease. They determined the rate of cardiovascular disease in people living with HIV as well as the considerable national, regional, and global burdens of cardiovascular disease on HIV patients.

Consisting of almost 800,000 people, this systematic, longitudinal study revealed that patients suffering from HIV are more than twice as likely to develop cardiovascular disease compared to those without HIV.

The study measured global and regional burdens in disability-adjusted life years (DALYs), where one DALY is one lost year of “healthy” life. When summed together over a global population, CVS researchers indicated that HIV-associated cardiovascular disease leads to over 2.6 million DALYs each year.

Currently, the link between HIV and heart disease is poorly understood. Scientists think the virus may inflame blood vessels, putting pressure on the cardiovascular system. HIV may also raise fat levels in the blood and affect the body’s ability to regulate sugar levels, which may contribute to heart disease.

The results of this massive systematic review have strong healthcare policy and treatment strategy implications, especially in those regions disproportionately affected by HIV-associated cardiovascular disease. A huge gap exists between the current health status and the ideal healthcare options for those living with HIV. This research indicates the need for more appropriate identification and treatment for those at risk of cardiovascular disease.

This study has important implications when planning cardiovascular preventative policies in low resource countries where the burden of HIV remains high and that of cardiovascular disease is growing.

Dr Anoop ShahClinical Lecturer of Cardiology at the University of Edinburgh

This CVS BHF-funded study was published in Circulation on 3 July, 2018.

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Original paper

Anoop Shah