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HIV and High Blood Pressure: What's the Link?

Medically Reviewed by Carmelita Swiner, MD on August 03, 2022

High blood pressure, also called hypertension, means the force of blood against your blood vessels is too high. It raises your risk for stroke, heart attack, heart failure, and other serious problems, especially if you don’t manage it carefully.

The human immunodeficiency virus (HIV) causes AIDS. Without treatment, the virus attacks your immune system and could lead to serious illness and even death.

Modern medicine has transformed HIV from a life-threatening disease to a manageable chronic, or long-lasting, condition. But as more and more people with the virus live to old age, doctors have noticed that if you’re HIV-positive, you're also more likely to have high blood pressure.

HIV and Your Risk For High Blood Pressure

Without HIV, there’s about a 30% chance you’ll get high blood pressure sometime in life. If you’re HIV-positive, that goes up to 35%.

In addition, high blood pressure is one of the biggest risk factors for heart disease, usually due to plaque, a gunky substance that builds up in your blood vessels and blocks blood flow. This could lead to:

  • Heart attack: A blood clot in your coronary arteries stops the flow of blood to part of the heart.
  • Stroke: A blood vessel that feeds your brain breaks (ruptures) or gets blocked by a blood clot, cutting off blood and oxygen to part of the brain. This could kill brain cells and lead to problems with speech, movement, and memory.
  • Heart failure: It’s when your heart doesn’t work hard or well enough to get oxygen and blood where it needs to go in your body.
  • Heart rhythm issues: Your heart may beat in a weird pattern (arrhythmia), too slowly (bradycardia), or too quickly (tachycardia).
  • Heart valve problems: These tiny gates in your heart chambers may not open wide enough to let enough blood in (stenosis) or might leak blood back (regurgitation) because the gates don’t close right or collapse (prolapse).

Heart disease adds to the problem because, even without high blood pressure, HIV could double your risk for heart disease.

Why Does HIV Raise Your Risk?

Doctors are still trying to figure out the reasons, but research points to some possibilities:

  • HIV keeps your immune system active all the time. This may inflame and stiffen your blood vessels.
  • HIV or the meds that treat it could cause changes in your gut bacteria that lead to inflammation in your blood vessels.
  • HIV raises your risk for kidney problems linked to high blood pressure
  • Antiretroviral therapy (ART) medications, which commonly treat HIV, may lead to conditions that cause inflammation.
  • High cholesterol levels in people with HIV could be linked to fewer hormones that process fat and keep blood sugar even.

How Do You Treat High Blood Pressure in People With HIV?

Scientists are studying whether they need to treat hypertension differently in people with HIV. Some early research shows that, at least in some cases, special medicines would help.

Doctors already know that HIV can complicate treatment for heart disease and other conditions linked to hypertension. For example, the class of drugs called statins that doctors prescribe for high cholesterol may affect the way your HIV medications work. These meds can also lead to high blood pressure.

Researchers are trying to figure out how HIV status might affect treatment and recovery from stroke and heart failure.

That’s why it’s always important to talk to your doctor about your health history and any drugs or medications you take, including supplements and recreational drugs.

You’ll also want to take a good look at your lifestyle. A number of things can make you less likely to have high blood pressure:

  • Limit salt: It could raise your blood pressure numbers.
  • Keep moving: Regular exercise helps lower heart disease risk.
  • Don’t smoke -- or try to quit if you already do. It’s one of the biggest risk factors for heart disease.
  • Don’t drink too much alcohol: That means no more than one drink a day for women, two for men.
  • Keep stress to a minimum: Too much raises your blood pressure.
  • Maintain a healthy weight: Ask your doctor to help you figure out if you’re carrying too many or too few pounds.
  • Eat healthy food: All those nutrients help your body fight disease and keep your weight steady.

Show Sources

SOURCES:

American Heart Association: “As HIV patients live longer, heart disease might be their next challenge,” “Atherosclerosis,” “Changes You Can Make to Manage High Blood Pressure,” “Older Americans & Cardiovascular Diseases,” “The Facts About High Blood Pressure,” “What is Cardiovascular Disease?” “What is high blood pressure?” “What's the connection between high blood pressure and HIV?”

CDC: “About Heart Disease,” “About HIV/AIDS.”

Hypertension: “Hypertension in HIV-Infected Adults.”

American Stroke Association: “About Stroke.”

Circulation: “Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association.”

Current Opinion in HIV and AIDS: “Hypertension in people living with HIV.”

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