Beta Blockers May Put HIV Patients at Higher Risk of Heart Disease, Stroke and Heart Failure

HIV patients taking beta blockers had 90 per cent higher risk of developing heart disease, heart failure or stroke for the first time compared to those who were taking ACEi/ARBs -- the most frequently prescribed type of high blood pressure medication, found a study.

By: Longjam Dineshwori | | Updated: April 6, 2021 7:42 am

People with HIV have about two times greater risk of heart disease and stroke than people not infected with the virus.

Though anti-retroviral therapy (ART) can’t cure human immunodeficiency virus (HIV), it is helping people with the condition to live longer and healthier lives. It also reduces the risk of HIV transmission and therefore, this treatment is recommended for everyone who has HIV. ART is the combination of several antiretroviral medicines that help suppress HIV replication and reduce viral load. But sometimes these medicines can cause side effects, a few of which can be serious. Some studies have found highly active antiretroviral therapy (HAART) associated with elevated blood pressure or hypertension, which is considered a significant cause of morbidity and mortality among HIV patients globally. But taking certain medications, like beta blockers, to lower blood pressure may also increase long-term risk of heart disease, stroke and heart failure in HIV-infected patients, suggested a new study. Also Read - Beta blockers will not make you depressed, but it can interfere with a good night’s sleep

The researchers studied records of 8,041 veterans with HIV (average age 53 years) who developed high blood pressure between 2000-2018. Of these, 25 per cent experienced a cardiovascular event during the mean 6.5 years follow-up period. Those taking beta blockers had 90 per cent higher risk of developing heart disease, heart failure or stroke for the first time compared to those who were taking ACEi/ARBs — the most frequently prescribed type of high blood pressure medication. Taking Thiazide diuretics and CCBs was not associated with this risk. However, beta-blockers were prescribed more frequently than CCBs among the study participants. Also Read - A breakthrough HIV drug can help optimize the immune system

What are beta blockers?

Beta blockers, also known as beta-adrenergic blocking agents, are one of the most widely prescribed medications to treat hypertension (high blood pressure). The drugs work by blocking the effects of the hormone epinephrine. Also known as adrenaline, the hormone triggers the body’s fight-or-flight response when you’re stressed. Beta blockers lower stress on the heart and blood vessels, causing your heart to beat more slowly and with less force, which in turn helps lower blood pressure. Also Read - Coronavirus outbreak: Docs using a cocktail of anti-HIV drugs to treat this deadly disease

People with HIV may be prescribed beta blockers to help control blood pressure. The new study, published in the journal Hypertension, also pointed out the high rates of beta-blockers prescribed for first-line hypertension treatment. This may be because many people with HIV receive primary care from their infectious disease team, who may not focus on blood pressure treatment guidelines and contraindications, the researchers said. They underscored that a patient’s primary care and infectious disease team should work together for the best possible outcomes.

The researcher team, including Jordana B Cohen, Assistant Professor at the University of Pennsylvania in Philadelphia, US, suspected that there could be potential interactions between blood pressure medications and some therapies used to treat the virus. They also indicated possible harm from sing beta-blockers as first-line treatment for hypertension whether a person has HIV or not.

How to manage blood pressure in HIV patients

According to a 2019 American Heart Association report, people who have HIV have about 1.5 to two times greater risk of heart disease and stroke than people not infected with the virus.

Cohen stated in their study report that blood pressure and heart disease risk in patients who have HIV can be safely managed with first-line treatment of hypertension with ACEis, ARBs, CCBs and thiazide diuretics and may have added benefit from initial treatment with ACEis and ARBs.

The new study also found the use of ACEi/ARBs associated with a lower risk of developing heart failure in patients with HIV who did not have chronic kidney disease. Those taking other medications were found to have about a 50 percent higher risk of heart failure.

Published : April 5, 2021 5:49 pm | Updated:April 6, 2021 7:42 am

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