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Anemia as a risk factor for cardiovascular disease in The Atherosclerosis Risk in Communities (ARIC) study
Mark J Sarnak1, Hocine Tighiouart, Guruprasad Manjunath
1Division of Nephrology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. msarnak@lifespan.org
Insights
Anemia is an independent risk factor for cardiovascular disease (CVD) in the general population. This study found anemia significantly increases the risk of developing CVD outcomes.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Epidemiology
Background:
- Anemia is a known risk factor for cardiovascular disease (CVD) in specific patient groups, including those with kidney disease or heart failure.
- However, its role as a CVD risk factor in the general population has not been extensively studied.
Purpose of the Study:
- To investigate whether anemia is an independent risk factor for cardiovascular disease (CVD) outcomes.
- To evaluate this association in a general population cohort.
Main Methods:
- Utilized data from the Atherosclerosis Risk in Communities (ARIC) study.
- Defined anemia based on hemoglobin levels (<13 g/dl in men, <12 g/dl in women).
- Employed Cox proportional hazards regression to analyze the relationship between anemia and CVD outcomes, adjusting for covariates in various subgroups.
Main Results:
- Included 14,410 participants without baseline CVD; 4.8% of men and 13.0% of women were anemic.
- During an average 6.1-year follow-up, 3.8% of participants experienced CVD events.
- Anemia was independently associated with a 41% increased risk of CVD (Hazard Ratio: 1.41 [95% CI: 1.01, 1.95]).
Conclusions:
- Anemia is confirmed as an independent risk factor for cardiovascular disease outcomes.
- This finding applies to the Atherosclerosis Risk in Communities (ARIC) cohort, comprising individuals aged 45-64 years.
Objectives:
We investigated whether the presence of anemia is a risk factor for cardiovascular disease (CVD) outcomes in the general population.
Background:
Chronic anemia is a risk factor for CVD outcomes in patients with kidney disease and in patients with heart failure, but has not been evaluated as a risk factor in the general population.
Methods:
The Atherosclerosis Risk in Communities (ARIC) study was used to evaluate the relationship of anemia, defined by hemoglobin <13 g/dl in men and <12 g/dl in women, to CVD. Cox proportional hazards regression was used to adjust the relationship between anemia and CVD outcomes for other covariates in the entire study cohort, as well as in subgroups of men, women, African Americans and whites.
Results:
A total of 14,410 subjects (6,267 men and 8,143 women) without CVD at baseline had hemoglobin levels measured. Three hundred men (4.8%) and 1,058 women (13.0%) were anemic. During an average follow-up of 6.1 years there was a total of 549 (3.8%) CVD events. The presence of anemia was independently associated with an increased risk of CVD (hazard ratio [95% confidence interval] of 1.41 [1.01, 1.95]) in the entire study cohort. In subgroup analyses the hazard ratios were in the same direction, although not statistically significant in all cases.
Conclusions:
Anemia is an independent risk factor for CVD outcomes in the ARIC cohort, a community cohort of subjects between the ages of 45 and 64 years.