Researchers have revealed that up to 10% of new coronary heart disease cases, which occur within a decade of middle age, can be avoided by preventing iron deficiency.
“This was an observational study and we cannot conclude that this was an observational study,” said study author Dr. Benedict Schrag, of the University of Hamburg’s Cardiovascular Center in Germany. Iron deficiency causes heart disease. However, evidence for a link is mounting and these findings provide the basis for further research to confirm the findings.”
Previous studies have found that in patients with cardiovascular conditions such as heart failure, iron deficiency was associated with worse outcomes including hospitalization and death. Treatment with intravenous iron improved symptoms, functional ability, and quality of life in patients with heart failure and iron deficiency enrolled in the FAIR-HF trial, which investigates the effect of intravenous iron supplementation on the risk of death in patients with heart failure.
The current study aims to examine whether the association between iron deficiency and outcomes is also observed in the general population.
The study included 12,164 individuals from three European population groups. The median age was 59 years, and 55% of the participants were women.
The researchers assessed cardiovascular risk factors and comorbidities such as smoking, obesity, diabetes and cholesterol through a comprehensive clinical assessment including blood samples.
The participants were classified as having iron deficiency or not according to two definitions:
1- Absolute iron deficiency, which includes only stored iron (ferritin).
2- Functional iron deficiency, which includes stored iron (ferritin) and circulating iron for use by the body (transferrin).
The researchers tracked participants’ status of coronary heart disease, stroke, death from cardiovascular disease, and death from all causes. They then analyzed the relationship between iron deficiency, coronary heart disease, stroke, cardiovascular mortality, and all-cause mortality after adjusting for age, gender, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation.
Participants with a history of coronary heart disease or stroke at baseline were excluded from the analyses.
60% of the participants had absolute iron deficiency and 64% had functional iron deficiency.
During the follow-up period of 13.3 years, there were 2212 deaths (18.2%). Of these, a total of 573 people (4.7%) died of causes related to cardiovascular disease.
Coronary heart disease and stroke were diagnosed in 1033 (8.5%) and 766 (6.3%) of the participants, respectively.
Functional iron deficiency was associated with a 24% increased risk of coronary heart disease, a 26% increased risk of cardiovascular death, and a 12% increased risk of all-cause death compared to no functional iron deficiency. Absolute iron deficiency was associated with a 20% increased risk of coronary heart disease compared to no absolute iron deficiency, but it was not associated with mortality. There were no associations between iron status and stroke.
The researchers calculated the cases that could have been avoided, taking into account age, gender, smoking, cholesterol, blood pressure, diabetes, body mass index and inflammation.
Dr. Charrag explained that the analysis indicates that if iron deficiency was absent in the first place, 5.4% of all deaths, 11.7% of cardiovascular deaths, and 10.7% of new diagnoses of coronary heart disease (all of which were attributed to iron deficiency) career), would not have occurred in the following decade.
He explains: “The study showed that iron deficiency was highly prevalent in this middle-aged population, with nearly two-thirds of them suffering from functional iron deficiency.”
These individuals were more likely to develop heart disease and more likely to die over the next 13 years.
Dr. Schrag noted that future studies should examine these associations in younger, non-European groups. “If the relationships are confirmed, the next step will be a randomized trial investigating the effect of iron deficiency treatment in the general population,” he said.
Source: Medical Express