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Study: HIV Linked to Increased Risk of Sudden Cardiac Death

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New research has found that people living with HIV have a higher risk of sudden cardiac death than those who are not living with HIV, according to the American Heart Association.

The findings, published Wednesday in the group’s Journal of the American Heart Association, examined more than 120,000 veterans in the U.S. living and not living with HIV. Those with HIV had a 14 percent higher risk of sudden cardiac death.

That number shot to 57 percent or 70 percent for veterans with high viral loads of HIV. The 70 percent came from people with HIV whose blood tests showed antiretroviral drugs were not suppressing the virus. It increased another 50 percent for each additional heart disease risk factor — such as smoking, anemia, high blood pressure, and hepatitis C.

“People living with HIV are already known to have a higher risk of heart attack, stroke, heart failure, blood clots in the lungs and peripheral artery disease,” said Dr. Matthew Freiberg, the lead author of the study and professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn.

“We know that among people with HIV, those who have a compromised immune system, for example a low total CD4+ T cell count, they seem to have a higher risk of cardiovascular disease than those who have high CD4+ T cell counts,” Freiberg added, according to a press release. “It is unclear if a compromised immune system is a risk factor for sudden cardiac death.”

Sudden cardiac death happens after the heart suddenly stops beating. This prevents blood flow to the brain and to the body’s organs, according to the American Heart Association. Death can occur in minutes if not treated.

A previous study from 2012 out of an HIV clinic in San Francisco found that sudden cardiac death was four times higher in those with HIV. This is a national study that takes into account viral loads and heart disease risk factors.

Participants were part of the Veterans Aging Cohort Study, which is a long-term, national study focusing on veterans. They were followed from 2003-2014. During that time sudden cardiac death was the cause of death for about 3,000 veterans, with 777 having HIV.

“Addressing risk factors related to both cardiovascular disease and HIV is essential to prevent the higher rates of sudden cardiac death in people with HIV,” said Dr. Zian Tseng, senior author of the study and a professor of medicine in residence at the University of California, San Francisco. “Clinicians should consider screening for specific warning signs of sudden cardiac death such as fainting or heart palpitations. And, if indicated, clinicians should request additional testing such as echocardiograms or continuous rhythm monitoring.”

The results, the researchers noted, are heavily male-focused, so it may not be as applicable to women. Moreover, the cause of death could also be due to drug overdoses, blood clots, or a stroke since the study only had a limited number of autopsies available. Autopsies, according to the researchers, are the best way to confirm the cause of death is cardiac arrest.

“In addition to HIV and cardiovascular risk factors, it is important for health care professionals to screen for and treat substance use disorders especially in people with HIV because they have a three times higher rate of overdose deaths presenting as cardiac arrest in our previous research,” Tseng said.

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