A team of researchers from John Hopkins Medicine has found that in people living with HIV or high levels of cholesterol, a six-week course of medication improved the function of the coronary arteries that provide oxygen to the heart.
A drug names PCSK9 inhibiter was used in the study. This drug lowers the activity of PCSK9, a protein involved in cholesterol metabolism. These levels are higher in people who have HIV and those with high cholesterol levels. The team found that a six-week course of this medicine improved the function of the coronary arteries that supply oxygen to the heart.
PCSK9 levels are higher in people with HIV and those with high cholesterol. Currently, HIV patients receive antiretroviral medications and rarely die from the virus itself. However, the same patients have an increased risk of cardiovascular disease as a result of chronic inflammation due to the virus, and they are significantly more likely to die from cardiovascular disease than the regular population.
The team suggested that there may be a way to control cardiovascular disease risk in those living with HIV and other cardiovascular risk factors, such as high cholesterol, by improving blood vessels’ function. Thorsten M. Leucker, M.D., Ph.D., assistant professor of medicine and the lead author of the study, explained that the team hypothesized that PCSK9 mediates an inflammatory response that impairs vascular function with its effects on cholesterol metabolism. They tested the process with the protein’s inhibitor to learning whether it could help people with impaired blood vessel function.
The team performed the study on 19 people with HIV and 11 people with high blood lipids, but HV patients were given the drug evolocumab, a PCSK9 inhibitor for six weeks. In the beginning, the team used cardiac magnetic resonance imaging (MRI) to measure the area and blood flow in the right coronary artery at rest and during a hand exercise, which usually results in relaxation of the blood vessels. When the test was performed on healthy people, the coronary artery responds to the exercise, and its area increases, allowing more blood to flow through.
In patients with impaired blood vessel function, the artery doesn’t get more substantial or may even constrict. Therefore, the blood flow remains the same or decreases in those with impaired blood vessel function.
After the course, the participants living with HIV had an average 7.9% increase in the coronary artery area and a 10.1% increase in blood flow during the handgrip exercise when compared to the resting value. These changes were higher than the changes from rest to handgrip exercise during the baseline pre-treatment visit. Participants with high blood lipids also had improved coronary artery areas and an increase in blood flow after six weeks of treatment. The team said further studies would be required to include more patients and study them over a longer time.