HIV and Opportunistic Infections, Coinfections, and Conditions

HIV and Heart Disease

Last Reviewed: August 10, 2021

Key Points

  • There are many types of heart diseases. Coronary heart disease is the most common type of heart disease, and it is the leading cause of death in the United States. In this fact sheet, the term “heart disease” refers specifically to coronary heart disease.
  • Heart disease is caused by the buildup of plaque inside the blood vessels (called the coronary arteries) that carry blood to the heart.
  • Risk factors for heart disease, such as high blood pressure or smoking, are the same for people with HIV and people without HIV. However, HIV and some HIV medicines may increase the risk of heart disease in people with HIV.
  • Lifestyle changes, such as eating a healthy diet, being more active, and quitting smoking, can help prevent and treat heart disease. Treatment for heart disease can also include medicines and surgery.

What is heart disease?

There are many different types of heart diseases. Coronary heart disease (also called coronary artery disease) is the most common type of heart disease. It is the leading cause of death in the United States. In this fact sheet, the term “heart disease” refers specifically to coronary heart disease.

What causes heart disease?

Heart disease is caused by the buildup of plaque inside the blood vessels (called the coronary arteries) that carry blood to the heart. Plaque is a waxy substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque buildup in the coronary arteries (called atherosclerosis) reduces the blood flow to the heart, which can cause chest pain (called angina) or a heart attack.

What are the risk factors for heart disease?

Some risk factors for heart disease can be changed or controlled by lifestyle changes or medicines, while other risk factors cannot. Risk factors that can be controlled to prevent or delay heart disease include the following:

  • High blood pressure (also known as hypertension)
  • High blood cholesterol levels
  • Diabetes
  • Eating an unhealthy diet
  • A lack of physical activity
  • Smoking
  • Being overweight or obese
  • Stress

Risk factors for heart disease that cannot be changed include having a family history of early heart disease and older age.

Are people with HIV at risk for heart disease?

Yes. The risk factors for heart disease are the same for people with HIV and people without HIV. However, HIV and some HIV medicines may increase the risk of heart disease in people with HIV.

Research is underway to understand the connection between HIV and heart disease. Go to ClinicalTrials.gov to find HIV research studies related to heart disease. For help with your search, call a Clinicalinfo health information specialist at 1-800-448-0440 or email HIVinfo@NIH.gov.

What are the symptoms of heart disease?

Some people who have heart disease have no symptoms. However, some people may have chest pain, shortness of breath, fatigue, or weakness. If you have any of these symptoms, contact your health care provider.

Chest pain that does not go away or occurs while a person is resting may be a sign of a heart attack. If you think you may be having a heart attack, call 9-1-1 immediately.

What is the treatment for heart disease?

Treatment for heart disease often includes lifestyle changes. For example, people with heart disease may change their eating habits, exercise more to lose weight, or quit smoking.

Medicines and surgery are also used to treat heart disease.

Medicines

Medicines used to treat heart disease include drugs to lower blood pressure, reduce cholesterol levels, or prevent or relieve chest pain. Some of these medicines may interact with HIV medicines. Health care providers carefully consider potential drug-drug interactions between HIV medicines and any other medicines a person may be taking.

Surgery

Coronary artery bypass grafting (CABG) is the most common type of surgery to treat heart disease in adults. During CABG, a healthy artery or vein from the body is used to bypass (go around) the blocked part of a coronary artery.

Visit the National Heart, Lung, and Blood Institute’s Heart Surgery webpage to learn more about the different types of heart surgery.

How can people with HIV reduce their risk of heart disease?

People with HIV can take the following steps to reduce their risk of heart disease:

  • Take HIV medicines every day to keep HIV under control.
  • Eat a healthy diet that includes lots of vegetables, fruits, and whole grains, and is low in saturated fats, added sugars, and salt.
  • Be physically active on a regular basis.
  • Quit smoking.
  • Keep all medical appointments. During medical visits, talk to a health care provider about the risk of heart disease.

For more information on how to lower your risk of heart disease, visit the How to Prevent Heart Disease webpage from MedlinePlus.

This fact sheet is based on information from the following sources:

From the Department of Health and Human Services:

From MedlinePlus:

From the National Heart, Lung, and Blood Institute:

Also see the HIV Source collection of HIV links and resources.