Featured VideoHow is HIV Related to Atherosclerosis?
Watch this video and listen to Dr. Salim Virani, a vascular specialist, explain how atherosclerosis happens and why people living with HIV are at higher risk.
People living with HIV are at greater risk for artery disease.
People living with HIV are at higher risk for artery blockage problems (or atherosclerosis, which is a build-up of plaque in the artery walls.) Therefore, they need to be sure to monitor and manage cholesterol levels–-both HDL and LDL-–and triglycerides.
How atherosclerosis happens
There are several reasons why HIV patients have a higher risk for atherosclerosis. First, let's look at how atherosclerosis happens.
- LDL invades the lining
LDL (the "bad" or low-density lipoprotein cholesterol particles) invades the lining of blood vessels, also called the intima.
- Inflammation signals white blood cells
Once inside, the cholesterol particles oxidize and cause an inflammation. The inflammatory response signals white blood cells to come in and engulf the invading particles of LDL.
- A mass accumulates
This flurry of cell activity causes the white blood cells and the cholesterol to accumulate, ultimately turning into a mass with a fibrous plug.
- Inflammation causes clots
The mass gets swollen and further inflamed. This condition may result in clots that break off and cause heart attacks or blockages inside narrowed arteries that do not allow blood to pass through.
HIV and Atherosclerosis
Anyone can get atherosclerosis. Here's why the HIV person has a greater risk.
- A higher amount of "bad cholesterol" (those LDLs mentioned above) is often seen in HIV patients.
- A lower amount of "good cholesterol" (HDLs) is to be expected when a patient is HIV positive. The good cholesterol helps keep the bad cholesterol from sticking. When there isn't enough HDL, the bad cholesterol builds up.
- T-cells or CD4s are also involved in the inflammatory response, and HIV is involved with the T-cells.
- Higher blood pressure weakens the artery walls. If there is more LDL circulating in the blood, it is logical that this LDL will more readily become lodged in the arteries.
HIV, Atherosclerosis and Prevention
So what does all this mean? You can't change your age, you can't change your HIV diagnosis, but you can change your cholesterol. You can make great choices for better health and lower risks. Simple, low-cholesterol food choices, exercise and medications can all improve your cholesterol ratios, with or without HIV.