Guide to side effects and complications
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Relative rate and actual risk
The most recent research suggests trying a range of products over the first week or two to cope with nicotine withdrawal such as patches, gum, inhalers and sprays so that you find the ones that work best for you.
Your HIV doctor can refer you to specialist services to help you quit.
The D:A:D study showed that the relative rate for an increased risk of heart disease form using a drug depends on your other risks factors. If you have a low cardiovascular risk, then a relative increase, even by 50% still remains a low real (absolute) risk. However, for someone with a high cardiovascular risk relating to other factors (age, smoking etc) then an increase in the relative risk from an HIV drug would be much more significant. For someone who has a high risk because of factors that can’t be changed (ie a family history of heart disease) then it is more important not to add to these risks by using any HIV drug with this potential side effect.
How to make lifestyle changes Changing the risk factors for heart disease can have a direct impact on future risk. By implication, this will also make HIV drugs safer to use. The advice given to the general population is even more important if you are using HIV treatment. • Stopping smoking is the most important lifestyle change in terms of general health and risk of heart disease. Support groups and other interventions including replacement therapy like nicotine patches are now available on the NHS.
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• Diet changes can significantly reduce your risk for heart disease. • Reducing fatty foods can reduce lipids to some extent. Cutting down on salt reduces blood pressure. Eating less processed sugars reduces your risk of developing insulin resistance and diabetes. • Eat more fruit and vegetables, fish and lean meat and reduce use of processed foods. • Exercise is the other main factor that you can change. Regular exercise and being more active in your day-today life, by walking more and using the lift less, is more important than very vigorous exercise.
Any change in level of activity will probably have to start gradually. People who start an exercise programme report benefits in quality of life. This can include increased well-being and energy levels.
The website for the North Central London Cardiac Network includes detailed guidelines for managing heart disease: http://www.nclcn.org.uk/
July 2012