"A lot of the studies so far have concentrated on medications," noted Dr. Priscilla Hsue, a cardiologist who is assistant professor of medicine at the University of California, San Francisco, and a member of the group preparing the report. "We've just begun to realize that the virus itself might be responsible. It affects the immune system and results in chronic inflammation, and both have effects on the cardiovascular system."
In terms of prevention, there should be an emphasis on well-known risk factors such as high blood pressure, obesity and smoking, Grinspoon and Hsue said. "We concentrate on smoking, because a lot of [patients with HIV] smoke cigarettes," she said. "But we must work on all the primary risk factors -- weight loss for obesity, family history, diabetes."
One important priority is to develop a cardiovascular risk factor profile that is specific for people infected with HIV, according to Grinspoon.
In terms of primary prevention of heart trouble, Hsue is a strong advocate for the use of daily aspirin. "It is really cheap and very effective at reducing heart attack and stroke," she said.
Close attention to risk factors is one part of "a two-prong approach," the other prong being development of more effective anti-HIV drugs, Grinspoon added. "The drug companies should develop medications with less side effects," he said.
But it is important for HIV-infected individuals to keep taking their HIV-suppressing drugs, he said. At least one study has shown a higher risk for people who went off and then back on HIV therapy, Grinspoon noted.
"It is definitely better to take your HIV medication," he said. "It is very positive. It saves lives."
Find out more on treating HIV infection at the U.S. Department of Health and Human Services.
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