Having HIV May Heighten Stroke Risk

People with HIV have a greatly increased risk of a common heart rhythm disorder that's a leading cause of stroke, a new study shows.

The increased risk of atrial fibrillation (AF) from HIV is similar to or higher than known risk factors such as diabetes and high blood pressure, according to researchers from the University of California, San Francisco (UCSF).

"This is the first paper demonstrating that HIV is a risk factor for AF, and the potency of that risk is similar to other well-established AF risk factors," said senior study author Dr. Gregory Marcus, associate chief of cardiology for research at UCSF.

"Because AF can be asymptomatic and stroke may be the first manifestation, it's important for caregivers to be aware of patients at heightened risk," he added in a university news release.

The analysis of data from nearly 17.3 million people in California showed that HIV infection was associated with an 80% higher risk of AF, 89% for high blood pressure and 22% for diabetes.

The association between HIV and AF risk was significantly higher in younger patients, blacks and Hispanics, and people without high blood pressure, diabetes or alcohol abuse.

The study was published Sept. 9 in the Journal of the American College of Cardiology.

Antiretroviral therapy has increased the life expectancy of people with HIV, but previous studies have shown that these patients are at increased risk for heart disease and sudden cardiac death, at least in part due to antiretroviral therapy.

Atrial fibrillation affects more than 2 million Americans, according to the National Stroke Association, and about 15% of people who have strokes have AF. Up to 80% of strokes in people with AF can be prevented, according to the association.

"Physicians caring for HIV-infected patients should be aware of this strong relationship" between HIV and AF, Marcus said.

"Increased awareness may help in recognizing the diagnosis and consequently result in more frequent prescription of appropriate therapies, such as anticoagulation [blood thinners], to reduce morbidity and mortality," he concluded.

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