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Other long-term conditions and GP management

High blood pressure and lipids

Blood pressure is the force that the beating heart causes in the arteries, veins, and blood vessels that carry blood around the body. If you have high blood pressure, your heart has to work harder to pump blood around your body. This can increase your risk of heart disease (see below), which can cause heart attack and stroke.

High blood pressure is commonly linked to lifestyle and diet (particularly being overweight), and these can also affect the amount of fats (lipids, also called cholesterol) in your blood. Ageing also increases the risk of high blood pressure. Some HIV treatments may increase the risks related to high blood pressure.

Blood pressure and lipid levels are checked as part of your routine HIV clinic care. However, GPs can help you to monitor and manage your blood pressure and lipid levels as part of your overall, long-term health care. They can prescribe any medication you may need to treat high blood pressure or high cholesterol (drugs called statins). You will probably have your weight, waist circumference and body mass index (BMI) measured at the same time, to see how healthy your body weight is.

Your GP may provide support services that can help you to address high blood pressure and high cholesterol, and to help you lose weight. See Referral to other services below for more information.

You can find out more about blood pressure, lipid levels and other health monitoring in NAM’s booklet CD4, viral load & other tests. You can read more about managing these conditions through diet in NAM’s booklet Nutrition.

Cardiovascular disease

Cardiovascular disease (CVD, or heart disease) is a common health condition in the UK. CVD is caused by high levels of fats (or lipids) in the blood, which block or narrow arteries. Untreated HIV can increase the risk of heart disease, but some evidence suggests high lipids and CVD can also be side-effects of some anti-HIV drugs. Your personal risk of developing heart disease can be affected by ethnicity, whether you are a man or a woman and family history, and risk increases as you age.

GPs are trained and experienced in the prevention, diagnosis and management of heart disease. Talk to your GP about working together to address any risk.

Your GP can prescribe treatments which may help to prevent or treat heart disease. GP practices offer coronary heart disease clinics, and some provide monitoring for people being treated with anticoagulants (medication to prevent blood clots). There is a risk of drug interactions between some anti-HIV drugs and drugs used to treat heart disease and its causes. For instance, some statins cannot be taken with some HIV drugs. It is important to tell your GP about any treatment you are taking.

Your risk of heart disease also has a lot to do with your lifestyle and diet, and these are areas your GP can provide advice and support on. See Referral to other servicesbelow for more information.

Diabetes

Diabetes is a disease where the amount of glucose (blood sugar) in the body is too high because the body cannot process it properly. Diabetes exists in two forms: Type 1, which usually occurs earlier in life; and Type 2, which usually develops as a person gets older (generally over 40 – although it can appear earlier, especially in people of Asian and African-Caribbean origin).

Some anti-HIV drugs have been associated with an increased risk of Type 2 diabetes; the risk is lower with the drugs most commonly used in the UK today. The risk of developing Type 2 diabetes also increases with age, and it is linked with lifestyle and diet, especially being overweight.

Your GP can advise you on how to reduce your risk of developing diabetes and test you for diabetes if necessary. If you have been diagnosed with diabetes, you will be monitored regularly, probably through a diabetes clinic. This is a service provided by all GP practices. Amongst other things, you will have your eyes, feet and nerves checked regularly, as they can be affected by diabetes. It is important to discuss any symptoms or concerns you have with the clinic nurse or your GP.

Mental health and emotional wellbeing

Mental health problems such as depression and anxiety can affect anyone, but evidence shows that people with HIV are more likely than the general population to experience them.

You can visit your GP about anything to do with your mental or emotional wellbeing. Your GP is a good access point for advice and support about your mental health. Your GP can make an assessment of your mental health and can prescribe treatments. These may include medication, such as antidepressants, or ‘talking therapies’, such as counselling.

If necessary, your GP can also refer you to specialist mental health services, such as a psychiatrist or community mental health team.

You can find out more about looking after your mental health and the help available in NAM’s booklet, HIV, mental health & emotional wellbeing.

Referral to other services

Your GP can often direct you to other services, if they do not provide them. Some of these are only available by being referred by a GP, such as specialist health care for other health conditions.  

Your GP will send a referral letter to the relevant specialist with an overview of your health and condition. You can ask for a copy of this letter. Your GP may recommend a particular specialist, or – in England – you can use the Choose and book system to choose a hospital or clinic (www.chooseandbook.nhs.uk). You can also tell your GP if you would like to use a private consultant. After you have seen the specialist, they will write back to your GP explaining their medical opinion and any action taken.

GPs can direct you to exercise facilities. If you’re not sure how to start exercising safely, ask your GP about the exercise on prescription programme. Exercise can be prescribed as a treatment for a range of conditions. Your GP may be able to refer you to a local ‘active health team’ for a fixed number of sessions under the supervision of a qualified trainer. Your GP and active health team will help you decide what type of activity will suit you best. Depending on your circumstances and what’s available locally, the exercise programme may be offered free or at a reduced cost.

Your GP may refer you to other services, such as local weight loss groups, stop smoking programmes, or services to help you reduce alcohol or drug use. These may be provided by the NHS or by commercial services that you pay for.

Community nursing. Community nurses (also called district nurses) can come to your home to provide care, and to help you manage your health. Community nurses are particularly helpful if you have recently been discharged from hospital. They can also help if you’re unable to travel to appointments for health reasons. Community nurses can help you take medication correctly, dress wounds, monitor your health and teach you and your carers how to manage health problems you may have.

Community mental health teams. CMHTs focus on working to help people with complex mental health conditions. They aim to provide the day-to-day support that is needed to allow a person to remain living in the community. 

Local authority services. GPs can also help you make contact with services run by your local council, such as children’s or adult social care services, if you feel you need more support in a particular area of your life.

HIV, GPs & other primary care

Published October 2012

Last reviewed October 2012

Next review October 2014

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.