Heart Risk To HIV Patients High

[+ Lucky]

What one hears nowadays is that a heart attack or stroke is the more likely thing to kill someone with HIV than the virus itself. It is not known if the it is the virus or the drugs used to treat it that cause the increased risk, but today the NY Times takes a deeper look into it. One doctor in the article seems surprised that HIV docs are not checking for cholesterol, blood pressure, heart rate, etc. I'd be shocked if that was true.

Here's the article, see what you think: http://www.nytimes.com/2012/06/19/health/heart-attacks-are-much-more-frequent-in-hiv-patients.html?hp

[doitb4ugo]

When I went onto HIV+ meds, my doctor needed to change the High Cholestrol meds due to incompatability...Had not been an issue until my annual checkup where my cholestrol readings were not good...particularly a low reading on the good cholestrol....we are keeping our eyes on it for now...I need to say that my doctor(an HIV specialist at Fenway Health), continually reminds me to not pay too much attention to what "facts" appear in the mainstream media....he claims in a good number of cases only a very small part of the whole picture is discussed....For what it is worth

[+ Lucky]

For what it is worth depends on if you are lying on the floor clutching your chest, doesn't it? I agree that we should not take too much from what we read on the internet, but a trend is a trend, and the trend seems to be more heart attacks with HIV. I think they apply to the long-term survivors more, but I did have a friend get a heart attack early on. He survived and is doing well.

[Guest]

There was no reputable article referenced in the NYT article. For definitive evidence, one needs a randomized clinical trial. Barring that, the next best thing is a cohort study in which one matches those with HIV with people without HIV, matched with similar patterns of smoking, drug use, sexual habits, and so forth. All the rest is chit-chat.

[+ Lucky]

There is plenty of evidence that the article is true. I agree that a medical doctor would like to see the studies, but they are there, and the layman needs to know that they are showing increased incidents of heart problems with people with HIV. But as I said before, if your doctor is not monitoring for cholesterol, blood pressure, heart rate, etc., then you need a new doctor.

[Guest]

There is plenty of evidence that the article is true. I agree that a medical doctor would like to see the studies, but they are there, and the layman needs to know that they are showing increased incidents of heart problems with people with HIV. But as I said before, if your doctor is not monitoring for cholesterol, blood pressure, heart rate, etc., then you need a new doctor.

I agree that there is no excuse for not following national guidelines with respect to blood pressure, cholesterol, glucose screening, and so forth. There are many possible explanations for an apparent higher rate of coronary disease in those with HIV. You just identified one, namely that some physicians/NPs/PAs may still have way outmoded beliefs such as "He's got HIV, so he's going to die anyways. Why bother with cholesterol?". Other possibilities include that HIV patients, as a group, tend to engage in riskier behaviors, such as drug use, smoking, unprotected (and probably also protected) sex, alcohol, and so forth. Yes, I realize that some people get HIV unknowingly from their spouses, but I'm speaking as a group. Although I don't specialize in HIV, I have a very healthy HIV patient in her mid-60s who got HIV because she didn't know what her (now ex-)husband was doing behind her back. She's a very religious woman who doesn't drink, smoke, or have sex. But that is not the case with the majority of my HIV patients. There's a reason competent doctors base their medical knowledge on bona fide medical articles, medical conferences put out by reputable unversities & organizations, and on national guidelines written by the consensus of national and world experts, rather than on chatty New York Times articles.

[+ Lucky]

We have no difference of opinion. A doctor darn well better be getting his information from medical sources as opposed to the common media. But patients are not usually in that chain of information, so will get the information from the media or word of mouth. Their job then is to take it to their doctor.