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Focus on the heart: alcohol consumption, HIV infection, and cardiovascular disease.

Freiberg MS, Kraemer KL - Alcohol Res Health (2010)

Bottom Line: These relationships can be partially explained by alcohol's effects on various risk factors for CVD, including cholesterol and other lipid levels, diabetes, or blood pressure.Excessive alcohol use can further enhance CVD risk in HIV-infected people through either of the mechanisms described above.In addition, excessive alcohol use (as well as HIV infection) promote microbial translocation, the leaking of bacteria or bacterial products from the intestine into the blood stream, where they can induce inflammatory and immune reactions that damage the cardiovascular system.

View Article: PubMed Central - PubMed

Affiliation: Center for Research on Health Care, University of Pittsburgh, all in Pittsburgh, Pennsylvania.

ABSTRACT
With the advent of effective antiretroviral therapy, people infected with HIV have a longer life expectancy and, consequently, are likely to develop other chronic conditions also found in noninfected people, including cardiovascular disease (CVD). Alcohol consumption, which is common among HIV-infected people, may influence the risk of CVD. In noninfected adults, moderate alcohol consumption can reduce the risk of coronary heart disease (CHD), heart attacks, and the most common type of stroke, whereas heavy drinking increases the risk of these cardiovascular events. These relationships can be partially explained by alcohol's effects on various risk factors for CVD, including cholesterol and other lipid levels, diabetes, or blood pressure. In HIV-infected people, both the infection itself and its treatment using combination antiretroviral therapy may contribute to an increased risk of CVD by altering blood lipid levels, inducing inflammation, and impacting blood-clotting processes, all of which can enhance CVD risk. Coinfection with the hepatitis C virus also may exacerbate CVD risk. Excessive alcohol use can further enhance CVD risk in HIV-infected people through either of the mechanisms described above. In addition, excessive alcohol use (as well as HIV infection) promote microbial translocation, the leaking of bacteria or bacterial products from the intestine into the blood stream, where they can induce inflammatory and immune reactions that damage the cardiovascular system.

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Related in: MedlinePlus

The association between alcohol consumption and cardiovascular disease. Excessive (hazardous) alcohol consumption can affect the blood vessels via its contribution to or frequent association with hypertension, abnormal levels of fat molecules (lipids) in the blood (i.e., dyslipidemia), insulin resistance, and smoking. All of these factors enhance the risk of plaque formation in the blood vessels. In addition, hazardous alcohol consumption can lead to excessive immune activation, which also can increase the risk of plaque rupture and blood clot formation, ultimately resulting in myocardial infarction and death.SOURCE: Balagopal et al. 2008; Vasan 2006.
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f1-arh-33-3-237: The association between alcohol consumption and cardiovascular disease. Excessive (hazardous) alcohol consumption can affect the blood vessels via its contribution to or frequent association with hypertension, abnormal levels of fat molecules (lipids) in the blood (i.e., dyslipidemia), insulin resistance, and smoking. All of these factors enhance the risk of plaque formation in the blood vessels. In addition, hazardous alcohol consumption can lead to excessive immune activation, which also can increase the risk of plaque rupture and blood clot formation, ultimately resulting in myocardial infarction and death.SOURCE: Balagopal et al. 2008; Vasan 2006.

Mentions: One of the consequences of HIV infection is a thinning (i.e., effacement) of the intestinal walls. Combined with the depletion of the immune cells attacked by HIV (i.e., the CD4 cells), this effacement allows bacteria living in the intestine or bacterial products (e.g., molecules called lipopolysaccharides) to leak across the gastrointestinal mucosa into the blood stream (Blagopal et al. 2008; Brenchley et al. 2006). This process is called microbial translocation. It may result in increased activation of the immune system, subsequent inflammation, and increased end-organ damage, including acute MIs and death (see the figure). Interestingly, hazardous alcohol consumption also is linked to microbial translocation among HIV-uninfected people (Keshavarzian et al. 1994; Purohit et al. 2008). Moreover, active liver disease (e.g., hepatitis resulting from alcohol use or HCV infection) may further exacerbate the effects of microbial translocation and immune activation either indirectly, because the body is no longer able to clear the microbial translocation products, or directly, because of the increased inflammation associated with the hepatitis (Balagopal et al. 2008). Similarly, it is possible that among HIV-infected and HIV/HCV-coinfected people alcohol consumption plays a major role in the progression to organ damage, CHD, and mortality.


Focus on the heart: alcohol consumption, HIV infection, and cardiovascular disease.

Freiberg MS, Kraemer KL - Alcohol Res Health (2010)

The association between alcohol consumption and cardiovascular disease. Excessive (hazardous) alcohol consumption can affect the blood vessels via its contribution to or frequent association with hypertension, abnormal levels of fat molecules (lipids) in the blood (i.e., dyslipidemia), insulin resistance, and smoking. All of these factors enhance the risk of plaque formation in the blood vessels. In addition, hazardous alcohol consumption can lead to excessive immune activation, which also can increase the risk of plaque rupture and blood clot formation, ultimately resulting in myocardial infarction and death.SOURCE: Balagopal et al. 2008; Vasan 2006.
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860509&req=5

f1-arh-33-3-237: The association between alcohol consumption and cardiovascular disease. Excessive (hazardous) alcohol consumption can affect the blood vessels via its contribution to or frequent association with hypertension, abnormal levels of fat molecules (lipids) in the blood (i.e., dyslipidemia), insulin resistance, and smoking. All of these factors enhance the risk of plaque formation in the blood vessels. In addition, hazardous alcohol consumption can lead to excessive immune activation, which also can increase the risk of plaque rupture and blood clot formation, ultimately resulting in myocardial infarction and death.SOURCE: Balagopal et al. 2008; Vasan 2006.
Mentions: One of the consequences of HIV infection is a thinning (i.e., effacement) of the intestinal walls. Combined with the depletion of the immune cells attacked by HIV (i.e., the CD4 cells), this effacement allows bacteria living in the intestine or bacterial products (e.g., molecules called lipopolysaccharides) to leak across the gastrointestinal mucosa into the blood stream (Blagopal et al. 2008; Brenchley et al. 2006). This process is called microbial translocation. It may result in increased activation of the immune system, subsequent inflammation, and increased end-organ damage, including acute MIs and death (see the figure). Interestingly, hazardous alcohol consumption also is linked to microbial translocation among HIV-uninfected people (Keshavarzian et al. 1994; Purohit et al. 2008). Moreover, active liver disease (e.g., hepatitis resulting from alcohol use or HCV infection) may further exacerbate the effects of microbial translocation and immune activation either indirectly, because the body is no longer able to clear the microbial translocation products, or directly, because of the increased inflammation associated with the hepatitis (Balagopal et al. 2008). Similarly, it is possible that among HIV-infected and HIV/HCV-coinfected people alcohol consumption plays a major role in the progression to organ damage, CHD, and mortality.

Bottom Line: These relationships can be partially explained by alcohol's effects on various risk factors for CVD, including cholesterol and other lipid levels, diabetes, or blood pressure.Excessive alcohol use can further enhance CVD risk in HIV-infected people through either of the mechanisms described above.In addition, excessive alcohol use (as well as HIV infection) promote microbial translocation, the leaking of bacteria or bacterial products from the intestine into the blood stream, where they can induce inflammatory and immune reactions that damage the cardiovascular system.

View Article: PubMed Central - PubMed

Affiliation: Center for Research on Health Care, University of Pittsburgh, all in Pittsburgh, Pennsylvania.

ABSTRACT
With the advent of effective antiretroviral therapy, people infected with HIV have a longer life expectancy and, consequently, are likely to develop other chronic conditions also found in noninfected people, including cardiovascular disease (CVD). Alcohol consumption, which is common among HIV-infected people, may influence the risk of CVD. In noninfected adults, moderate alcohol consumption can reduce the risk of coronary heart disease (CHD), heart attacks, and the most common type of stroke, whereas heavy drinking increases the risk of these cardiovascular events. These relationships can be partially explained by alcohol's effects on various risk factors for CVD, including cholesterol and other lipid levels, diabetes, or blood pressure. In HIV-infected people, both the infection itself and its treatment using combination antiretroviral therapy may contribute to an increased risk of CVD by altering blood lipid levels, inducing inflammation, and impacting blood-clotting processes, all of which can enhance CVD risk. Coinfection with the hepatitis C virus also may exacerbate CVD risk. Excessive alcohol use can further enhance CVD risk in HIV-infected people through either of the mechanisms described above. In addition, excessive alcohol use (as well as HIV infection) promote microbial translocation, the leaking of bacteria or bacterial products from the intestine into the blood stream, where they can induce inflammatory and immune reactions that damage the cardiovascular system.

Show MeSH
Related in: MedlinePlus