Pulmonary Hypertension More Frequent in US Veterans with HIV

Pulmonary hypertension is a condition with elevated blood pressure in the pulmonary artery (i.e the arteries in the lungs and heart) that can eventually lead to heart failure. A study to determine if persons living with HIV compared to those without HIV suffer more pulmonary hypertension was completed. It used data from the ongoing large Veterans Aging Cohort Study (VACS). 

Out of13,028 veterans 4,174 (32%) were HIV-positive and 8,854 (68%) were HIV-negative. Most were men with a median age of about 58 years. At the beginning of the study, about a third had chronic obstructive pulmonary disease (COPD) but no evidence of heart failure. In addition, the health records were reviewed to find out whether information on file could indicate pulmonary hypertension. This process used information from ultrasound imaging of the pulmonary artery. 

The veterans were followed for about 3 years. At the end of the period, the presence of pulmonary hypertension- as indicated by an elevated pulmonary artery systolic pressure- was found in 468 veterans with HIV and 904 without HIV.  Even after ruling out the possible effects of COPD, diabetes, smoking, and other factors that might contribute to pulmonary hypertension, the frequency was still 18% higher in those with HIV when compared to those without HIV. The reasons for this problem include the possible effect of a low CD4 count or a high viral load. Although more medical research is necessary, this reflects the need to increase CD4 counts and lower viral loads with more effective therapy.


Source: Meredith S Duncan, et al. (2021) Association between HIV and incident pulmonary hypertension in US Veterans: a retrospective cohort study. Lancet Health Longevity 2021;2:e417-25