New research has found a concerning connection between anemia and cardiovascular diseases such as atrial fibrillation (AFib) and heart failure. Dr. Michael Goyfman, chief of cardiology and director of echocardiography at Northwell Long Island Jewish Forest Hills in New York, explains that anemia, which is characterized by a scarcity of red blood cells or hemoglobin, can lead to decreased concentration of red blood cells and require the heart to pump harder or faster to meet the body’s demands. This increased strain on the heart can exacerbate underlying heart conditions.
Heart failure is a condition in which the heart fails to pump sufficient blood to meet the body’s demands and affects approximately 6.5 million Americans over the age of 20. AFib, the most common form of irregular heartbeat, currently affects over 5 million U.S. adults, with projections suggesting that the number will climb to around 12.1 million by 2030.
One factor contributing to anemia is iron deficiency, which inhibits the production of healthy red blood cells. Inflammation can also disrupt iron metabolism, impairing red blood cell production. A review conducted in 2022 revealed a strong association between iron-deficiency-related anemia and AFib. Restoring iron levels was found to be an effective treatment for this irregular heartbeat.
Anemia has also been linked to other conditions such as cardiac hypertrophy (thickening of the heart muscle walls), angina (heart pain), and multiorgan failure. Risk factors for anemia include poor diet, intestinal disorders, chronic diseases, infections, menstruation, pregnancy, chronic medical conditions, and age.
Certain medications can also contribute to anemia. Drug-induced immune hemolytic anemia is a condition triggered by medications such as antibiotics like penicillin and cephalosporins. Additionally, cancer treatment medications can cause myelosuppression, where the bone marrow reduces the production of various blood cells, including red blood cells.
Low-dose aspirin, commonly used to prevent blood clots leading to heart attacks or strokes, has been associated with an increased risk of anemia in individuals aged 65 and older. A clinical trial monitored more than 19,000 participants and found that the daily aspirin group had a 20% higher likelihood of developing anemia within five years than the placebo group.
Long-term use of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, has also been linked to an increased risk of anemia and iron deficiency.
While anemia is associated with heart failure, it is uncertain if there is a causal relationship between the two. The question of whether increasing dietary iron levels can reduce the associated heart risk remains unanswered. At present, there is no evidence demonstrating improved outcomes in heart disease patients by maintaining higher iron levels.
To address anemia, physicians should follow current guidelines until further evidence emerges. The recommended daily allowance of iron for adults varies depending on age and sex, with men needing approximately 8 milligrams per day and women requiring around 18 milligrams per day. Pregnant women and those breastfeeding may need higher amounts.
In conclusion, the link between anemia and cardiovascular diseases highlights the importance of addressing anemia as a risk factor for heart conditions. Further research is needed to determine the causal relationship between anemia and heart disease, as well as to explore the potential benefits of maintaining higher iron levels in reducing heart risk.
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