In a new study from the University Heart and Vasculature Centre Hamburg, researchers found approximately 10% of new coronary heart disease cases occurring within a decade of middle age could be avoided by preventing iron deficiency.
Previous studies have shown that in patients with heart diseases such as heart failure, iron deficiency was linked to worse outcomes including hospitalizations and death.
Treatment with intravenous iron improved symptoms, functional capacity, and quality of life in patients with heart failure and iron deficiency.
In the study, the team aimed to test whether the association between iron deficiency and outcomes was also observed in the general population.
The study included 12,164 individuals from three European population-based cohorts. The median age was 59 years and 55% were women.
Participants were classified as iron deficient or not according to two definitions: 1) absolute iron deficiency, which only includes stored iron (ferritin); and 2) functional iron deficiency, which includes iron in storage (ferritin) and iron in circulation for use by the body (transferrin).
Absolute iron deficiency is the traditional way of assessing iron status but it misses circulating iron.
The functional definition is more accurate as it includes both measures and picks up those with sufficient stores but not enough in circulation for the body to work properly.
Before the study, 60% of participants had absolute iron deficiency and 64% had functional iron deficiency. During a follow-up of 13 years, there were 2,212 (18.2%) deaths.
The team found functional iron deficiency was linked to a 24% higher risk of coronary heart disease, 26% raised risk of heart mortality, and 12% increased risk of all-cause mortality.
Absolute iron deficiency was linked to a 20% raised risk of coronary heart disease compared with no absolute iron deficiency, but was not linked with mortality.
The researchers then estimated the proportion of events in 10 years that would have been avoided if all individuals had the risk of those without iron deficiency at baseline.
Within a 10-year period, 5.4% of all deaths, 11.7% of cardiovascular deaths, and 10.7% of new coronary heart disease diagnoses were attributable to functional iron deficiency.
This analysis suggests that if iron deficiency had been absent in the beginning, about 5% of deaths, 12% of cardiovascular deaths, and 11% of new coronary heart disease diagnoses would not have occurred in the following decade.
The study showed that iron deficiency was highly prevalent in this middle-aged population, with nearly two-thirds having functional iron deficiency.
These individuals were more likely to develop heart disease and were also more likely to die during the next 13 years.
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The study is published in ESC Heart Failure. One author of the study is Dr. Benedikt Schrage.
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