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In medical practice, iron deficiency appears to increase the risk of heart disease in middle age


Iron deficiency heart disease?

Many middle-aged coronary artery disease appears to be associated with iron deficiency. According to a recent study, not only absolute iron deficiency, but also functional iron deficiency plays a crucial role. Prevention of iron deficiency can significantly reduce the risk of coronary artery disease.

A current study involving researchers from Helmholtz Zentrum Munich and the University of Cardiology at the University of Hamburg in UKE aims to examine whether there is a link between iron deficiency and treatment outcomes in cardiovascular disease. The results can be found in the English-language journal ESC Heart Failure of the European Society of Cardiology (ESC).

Does iron deficiency cause heart disease?

“This study is an observational study, and we cannot conclude that iron deficiency causes heart disease,” said study author Dr. Benedict Schrage, in a press release from the European Society of Cardiology. But there is growing evidence that there is a connection.

Researchers have shown that previous studies have shown that iron deficiency in people with cardiovascular disease (such as heart failure) is associated with worse outcomes, including hospitalization and death.

Benefits of intravenous iron therapy

Intravenous iron therapy improved symptoms, function, and quality of life in people with heart failure and iron deficiency who participated in the FAIR-HF study. Based on these results, the FAIR-HF-2 study examines the effect of intravenous iron intake on the risk of death in people with heart failure. Experts analyzed the link between iron deficiency and treatment outcomes in the general population.

Existing cardiovascular risk factors are identified

The current study included 12,164 people with an average age of 59 years and 55 percent of participants were women. The first study identified cardiovascular risk factors and diseases such as smoking, obesity, diabetes and high cholesterol through a comprehensive clinical examination, including blood samples.

Participants were then classified as iron-poor or iron-poor according to two definitions. One definition was definitely iron deficiency, where only stored iron (ferritin) is considered. Experts explain that the second definition was functional iron deficiency, which takes into account stored iron (ferritin) and circulating iron (transferrin) for use by the body.

“Absolute iron deficiency is a traditional way of assessing the condition of iron, but does not take into account circulating iron. The functional definition is more accurate because it contains metrics and captures those who have enough supply for the body to function properly but do not have enough iron in the blood,” said Dr. . Slope.

Participants were then medically monitored for coronary artery disease and stroke, deaths from cardiovascular disease, and deaths from all causes.

Which people were left out of the study?

The team analyzed the relationship between age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and coronary artery disease, stroke, cardiovascular mortality, and all-cause mortality after adaptation to inflammation. If participants already had coronary artery disease or stroke at the beginning of the study, they were excluded from the analysis of previous illnesses.

At the beginning of the study, 60 percent of participants had absolute iron deficiency and 64 percent had functional iron deficiency. There were 2,212 (18.2 percent) deaths during the 13.3-year follow-up period. Of these, a total of 573 people (4.7 percent) died of cardiovascular disease. 1033 (8.5 percent) and 766 (6.3 percent) participants were diagnosed with coronary artery disease and stroke.

Increased risk due to functional iron deficiency

According to the researchers, functional iron deficiency had a 24 percent higher risk of coronary artery disease, a 26 percent higher risk of cardiovascular death, and a 12 percent higher risk of all-cause death compared to people without functional iron deficiency.

There is no connection between iron status and stroke

Absolute iron deficiency was associated with a 20 percent increased risk of coronary artery disease compared to no iron deficiency, but was not associated with death. The team believes that there is no connection between the status of the iron and the incidence of stroke.

5.4 percent of all deaths are due to functional iron deficiency

Experts estimate that about 5.4 percent of all deaths, 11.7 percent of cardiovascular deaths, and 10.7 percent of new diagnoses of coronary artery disease are related to functional iron deficiency over a ten-year period.

“This analysis shows that without iron deficiency at the beginning of the study, about five percent of deaths, twelve percent of cardiovascular deaths and eleven percent of new diagnoses of coronary artery disease would not occur in the next decade.” said Dr. Slope.

Middle-aged iron deficiency is very common

The study shows that iron deficiency is widespread in the middle-aged population studied, and almost two-thirds show functional iron deficiency. People suffering from iron deficiency were at a higher risk of developing heart disease and dying over the next 13 years, the doctor continued. In the future, additional work will be done to explore connections between younger and non-European groups. (whom)

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Author and source information

This text complies with the requirements of specialized medical literature, medical guidelines and current research and has been verified by medical professionals.


  • Benedict Schrage, Nicole Rübsamen, Francisco M. Ojeda, Barbara Thorand, Annette Peters, and others: The association of iron deficiency incidents with cardiovascular disease and mortality in the general population; inside: ESC heart failure (veröffentlicht 05.10.2021), ESC heart failure
  • European Society of Cardiology: Iron deficiency in middle age is associated with an increased risk of developing heart disease (veröffentlicht 06.10.2021), ESC

Important Note:
This article is for general instruction only and is not used for self-diagnosis or self-medication. It cannot replace a doctor’s visit.

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