Drinking Worsens HIV+ Cardiovascular Risks

posted: 23/12/2009

Heavy drinking increases the risk of cardiovascular disease for men with HIV, a USA study shows. “Hazardous drinking and alcohol abuse or dependence were significantly associated with an increased prevalence of cardiovascular disease as compared with infrequent or moderate drinkers”, they comment.
 

Even 'light-weight' drinking harms more with HIV

What they mean by 'hazardous drinking' may seem pretty light-weight to men on the gay scene in England. They counted anything over 14 alcoholic drinks in one week as hazardous, and six drinks in a single session, more than once a month, as binge-drinking. At Christmas and New Year many men will be drinking well over these.
 

They emphasise that the study shows the risks of heart and other circulation disease harm is there for men with HIV, even after they took account of the usual risks.

We already know drinking is linked to several health problems in people with HIV. These include

• poor adherence to HIV treatments
• liver disease
• worsening HIV disease, as well as a
• bigger risk of cardiovascular disease.

Among HIV negative people, heavy drinking, binge drinking and alcohol dependency, are well known to cause more heart disease and strokes. Is this the same or worse for people with HIV, was the question this study investigated.

So the US investigators studied 4743 HIV positive and negative men veterans from the USA armed forces. Just over half the men (2422, 51%) were HIV-positive. Both HIV-positive and HIV-negative men were likely to be hazardous drinkers, or to binge drink, or be dependant on alcohol - alcoholics.

HIV negative more likely to have some drinking risks

The HIV negative men were statistically more likely to have several traditional risk factors for cardiovascular disease than HIV positive men. These risks include

• having high cholesterol,
• diabetes,
• high blood pressure and
• being overweight.

HIV positive men have more of these usual drinking risks

HIV positive men were statistically more likely to

• smoke,
• have hepatitis C, and
• have liver disease.

So the study shows HIV-positive, but not HIV-negative men, who are hazardous drinkers or alcohol dependent have a higher risk of cardiovascular disease.

Similar drinking risks shared by positive and negative men

For both HIV-positive and HIV-negative men, these traditional risk factors 

• being older,
• higher cholesterol,
• high blood pressure, and
• smoking

were also significantly associated with more cardiovascular disease.

Affect of HIV on drinking men

They then looked more closely at how HIV itself affects the risks for men with HIV, by taking out of the equation the traditional risk factors for cardiovascular disease.

 

HIV and drinking – more heart failure, heart disease, cardiovascular disease, strokes
 

They found that hazardous drinking for men with HIV was significantly linked with heart failure; that alcohol dependency was linked to heart disease, and that past alcohol consumption (defined as one or more drink, ever), increased the risk of stroke. Binge drinking increases the risk of cardiovascular disease for those with HIV. [The source quotes how strong these statistical significances are].

“Among HIV-infected veterans, there was a significant increase in the prevalence of cardiovascular disease for hazardous drinking and alcohol abuse”, write the investigators. They suggest that this could partly be explained by the increases in lipids associated with heavy drinking. However, they also note that previous research among this group of US veterans “also demonstrated a temporal and dose-response relationship between alcohol consumption and medication adherence.”

“The effect of alcohol may be more pronounced among those infected with HIV”, conclude the investigators.

How does your own drinking measure up?

One of our earlier articles includes useful weblinks to drink calculators to help you check how much you are drinking and it also tells you where you can get help to cut your drinking down.

Drinking is a common way for men with HIV to manage stress and to socialise, but there is quite a price to pay down the line. As men with HIV live longer because of better HIV treatments, it is more likely men with HIV will die earlier than necessary of alcohol-related cardiovascular disease, [heart attacks, heart failure, strokes, blocked arteries], than of HIV.

 

Men with HIV who tick these risk boxes, as well as drinking, worsen their life prospects

• smoker
• overweight
• older
• have higher cholesterol
• high blood pressure
• have hepatitis C
• have liver disease
• diabetic.

The more you tick, the higher the risk of harming health and life.

British Heart Foundation page on cardiovasular disease and how to cut your risks

Source

Reference Freiberg and others. The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men. J Acquir Immune Defic Syndr 2009.
 

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