There have been previous studies suggesting that people with H.I.V. develop High cholesterol and blocked arteries about a decade earlier than normal, but that is only now becoming widely recognized.

“I didn’t know I had a heart problem until I had a heart attack and a double bypass in 2003,” said Mark Abramson, 59, author of the “Beach Reading” series of gay mystery/romance novels.

Although he saw doctors and was intermittently taking AIDS medication when he had medical insurance during his years as a bartender, “no one told me I was in a high-risk group.”

He smoked and knew his blood pressure was “a little high.” He did not remember any cholesterol tests.

Sharon Hampton, 57, had heart trouble first and only later learned of a likely connection to the virus.

In her 30s, she developed high blood pressure and signs of congestive heart failure. A self-professed workaholic, she blamed the pressure of her job as a hospital claims processor. Her physician advised her to find something less stressful; she did for a while, but then moved to Sacramento and started working at another hospital.

At age 45, she said, “I had a heart attack right at my desk - thank God the E.R. was only seven feet away from the business office.”

After a quintuple bypass, she initially went back to work. But her health deteriorated, and she has lived with family members since.

Last Thanksgiving, after a health crisis hospitalized her, she learned she had H.I.V.

“I couldn’t believe it,” she said. “I totally freaked out. I thought it had to be a false positive. I’ve been celibate for a long time. I never had that lifestyle. I’m afraid of drugs.”

But when she was young, she said, she was briefly married to a man she later learned injected drugs.

“I just never knew,” she said. “He was Michelangelo’s David. I was a country bumpkin.”

She is apparently a rare “elite suppressor,” part of the 1 to 2 percent of the infected who, for unknown reasons, control the virus without drugs. Although she has a nearly undetectable viral load and no opportunistic infections, her doctors at U.C.S.F. believe that the virus contributed to her heart problems.

Jose Raneda, a 48-year-old former lawyer from Milwaukee, has seen the thinking about the H.I.V.-heart connection change in the last few years.

He has known he was infected since he was 21, started on AIDS cocktails as soon as they were available, never had a low CD4-cell count or an AIDS-related infection, and has always been slim.

But he had his first of two heart attacks at age 40.

“I asked my H.I.V. doctor if it was related, and he said it wasn’t,” he said. “I think he was mistaken.”

His former physician, Dr. Ian H. Gilson of the Medical College of Wisconsin, agreed.

“At the time, we didn’t have a lot of solid evidence of the connection,” he said. “My thinking has evolved. I’d tell him something different now.”

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By DONALD G. McNEIL Jr.