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Hints for a happy heart

Positive Living article • Adrian Ogier • 8 June 2012

The purpose of taking a fish oil supplement is to give you a good dose of the cholesterolAn essential component of cell membranes and nerve fibre insulation, cholesterol is important for the metabolism and transport of fatty acids and the production of hormones and Vitamin D. Cholesterol is manufactured by the liver, and is also present in certain foods. High blood cholesterol levels have been linked to heart disease and may be a side effect of some anti-HIV medications. lowering omega-3 essential fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fish such as mackerel, tuna, salmon and sardines are good sources of both of these as are those small shrimp-like crustaceans called krill. But despite all the hype surrounding krill oil, it appears to be no better than standard fish oil and may in fact impart less benefit.1

This was one of the tips offered at a session on lowering the risks of cardiovascular disease (CVD) for positive people, held in Sydney recently.

The session was targeted at treating doctors but much of the content was simply good advice.

Professor Andrew Carr, who heads the HIV, Immunology and Infectious Diseases Unit at St Vincent’s Hospital, was one of the experts on the panel.

‘Everyone should have their CVD risk assessed,’ he advised.

‘Remember, it is the overall CVD risk not just total cholesterol that matters. Those at low risk probably require no interventions at all, while those at higher risk may first need to look at modifying certain lifestyle factors.’

Doctors at the meeting suggested the obvious: lose weight if you’re overweight, eat well, exercise more and, of course, stop smoking.

Smoking is one of the biggest modifiable risk factors for CVD. Combine this with some other non-modifiable risk factors like a family history of CVD, being male and being older; and then throw HIV into the mix and your risk of CVD is getting up there.

‘There are no good data telling us whether it is better to lower cholesterol by using drugs like statins, or by changing your ARVA medication or other substance which is active against retroviruses such as HIV. regimen to one that doesn’t include a protease inhibitor (PI) or abacavir,’ Prof. Carr advises.

‘For many people, competing health risks such as neurocognitive impairment, HIV drug resistanceHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. or renal disease might make a PI and abacavir-based combination the best choice overall despite any CVD risk they bring.’

If you are looking at reducing your LDL levels by taking a statin medication, Crestor and Lipitor are probably the most potent and effective, however an older drug, Pravastatin, may still be effective and has fewer side effects.

If you’re interested in learning more, the Heart Foundation has developed a new consumer resource for PLHIVPerson (or people) Living with HIV. This term is now preferred over the older PLWHA. about our risk factors for heart disease. 'Cardiovascular wellness for people living with HIV' is available in print and as an interactive online resource with links to further information.

The brochure contains information on smoking, nutrition, salt, physical activity, healthy weight, blood pressure, cholesterol, alcohol, and social and emotional wellbeing. Plus there’s a section on treatments and another on recreational drug use.

The resource will be officially launched on Monday 9 July. Go here for more information www.heartfoundation.org.au/hiv

  1. 1. Ulven, Stine M. et al Metabolic Effects of Krill Oil are Essentially Similar to Those of Fish Oil but at Lower Dose of EPA and DHA, in Healthy Volunteers Lipids (2011) 46:37–46
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From Positive Living

This article was first published in the June 2012 issue of Positive Living.

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