Sudden Cardiac Death Risk Higher in HIV Patients

Sudden cardiac death, which occurs when the heart unexpectedly stops, was second only to AIDS as a leading cause of death among HIV patients in a new 10-year study. The results indicate that even if their virus is under control and they appear relatively healthy, HIV-positive people are 4.5 times more likely to die of sudden cardiac arrest than HIV-negative individuals.

Among the study's subjects -- 2,860 HIV patients receiving treatment at San Francisco General Hospital's (SFGH) HIV/AIDS ward from 2000 to 2009 -- 230 died: 57 percent from AIDS, 13 percent from sudden cardiac death, 11 percent from other natural diseases, and 19 percent from suicides, overdoses or unknown causes. Eighty-six percent of the cardiac deaths occurred suddenly, compared to about half of all heart-related deaths in the general population.

Among those who suffered sudden cardiac death, more than half had a history of smoking, heavy drinking or drug use; 80 percent already had been diagnosed with heart disease or had one or more risk factors; and one-third reported symptoms like chest pain or shortness of breath at their last clinic visit. Their T-cells counts were only slightly below average for all study patients.

Half the patients for whom lab results were available had undetectable viral loads when they died, suggesting that HIV alone is not causing the heart problems, according to authors Dr. Zian Tseng, a University of California-San Francisco electrophysiologist, and Dr. Priscilla Hsue, director of the HIV Cardiology Clinic at SFGH, and colleagues. They noted that HIV causes inflammation that could affect the heart. In addition, some HIV drugs are known to interrupt the heart's electrical activity.

Thanks to effective treatment, Hsue said some HIV patients who were initially reluctant to adopt healthier lifestyles now are thinking, "'I could live another 25 years if I take care of myself.' And I'm really hammering on stop smoking, take blood pressure medication, watch your cholesterol."

[PNU editor's note: The study, "Sudden Cardiac Death in Patients with Human Immunodeficiency Virus Infection," was published in the Journal of the American College of Cardiology (2012;59:1891-1896).]

Back to other news for May 2012