As has been pointed out, many factors contribute to cardiovascular disease. What's more, not all factors carry the same risk—some are much more serious than others. For example, smoking has been proven to substantially increase the risk of heart disease, as has diabetes. Being 30 pounds overweight might also increase your risk, but not to the same degree as smoking. While these principles have been well established in studies involving HIV-negative people, most experts agree that the same principles apply to HIV-positive people as well.
Let's use smoking as an example. Below are two people with the same cardiovascular risk factors, with the exception of smoking. The risk of a heart attack during the next 10 years in the smoker, compared with the non-smoker, is doubled:
| |
Patient A |
Patient B |
| Gender? |
Male |
Male |
| Age (yrs)? |
45 |
45 |
| Smoker? |
Yes |
No |
| Family history of heart disease? |
Yes |
Yes |
| Any heart disease events? |
No |
No |
| Has diabetes? |
No |
No |
| Blood sugar over 100 mg/dL? |
No |
No |
| Height? |
5' 10" |
5' 10" |
| Weight? |
185 lbs |
185 lbs |
| Waist greater than 36 inches (women) or 40 inches (men)? |
No |
No |
| Systolic blood pressure? |
134 |
134 |
| Diastolic blood pressure? |
80 |
80 |
| Currently taking blood pressure medications? |
No |
No |
| Total cholesterol? |
290 mg/dL |
290 mg/dL |
| LDL cholesterol? |
165 mg/dL |
165 mg/dL |
| HDL cholesterol? |
36 mg/dL |
36 mg/dL |
| Triglycerides over 150 mg/dL? |
Yes |
Yes |
| Ten-year risk of a heart attack: |
30 % |
16 % |
These estimates did not come out of thin air—they were generated by an on-line risk calculator that has been set up and verified by the Expert Panel on Detection, Evaluation, and Treatment of High Cholesterol in Adults (working directly under the National Heart, Lung and Blood Institute of the National Institutes of Health). While it does not take into consideration certain HIV risk factors—such as the effect of ARV medications and HIV infection itself—experts agree that the calculator is a useful tool for HIV-positive people and their health care providers when evaluating cardiovascular risk. A simple version of the calculator can be accessed by clicking here.
The next section reviews some of the things you, working alongside your health care provider, can do to reduce the risk of cardiovascular disease.
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