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Published on: May 4, 2020
Haem Iron Intake Is Associated with Increased Major Adverse Cardiovascular Events, All-Cause Mortality, Congestive
R Luong1, R V Ribeiro, A Rangan
1Rebecca Luong, Level 4, Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia, rebecca.luong@sydney.edu.au.
Insights
Higher intake of heme iron from animal sources is linked to increased cardiovascular risks in older men. Non-heme iron from plant sources may reduce mortality risk.
Area of Science:
- Cardiovascular Health
- Nutritional Science
- Gerontology
Background:
- Dietary nutrition significantly impacts cardiovascular health.
- Dietary iron exists as heme iron (HI) in animal products and non-heme iron (NHI) in plant-based foods.
- Understanding iron's role in cardiovascular events is crucial for public health.
Purpose of the Study:
- To investigate the association between dietary heme iron (HI) and non-heme iron (NHI) intake and major adverse cardiovascular events (MACE).
- To examine the relationship between dietary iron intake and iron status biomarkers in older men.
Main Methods:
- A prospective cohort study involving 539 older Australian men (≥75 years).
- Dietary iron intake (HI and NHI) was assessed using a validated diet history questionnaire.
- Cox regression models analyzed associations between iron intake and MACE, with linear regression for iron biomarkers.
Main Results:
- Higher HI intake correlated with increased risks of all-cause mortality, myocardial infarction, congestive cardiac failure, and coronary revascularisation.
- Middle tertile NHI intake was associated with a reduced risk of all-cause mortality compared to the lowest tertile.
- Total iron intake and dietary iron forms were not significantly associated with serum iron or hemoglobin levels.
Conclusions:
- Elevated heme iron consumption is an independent risk factor for major adverse cardiovascular events in elderly men.
- Non-heme iron intake may offer a protective effect against all-cause mortality.
- Further research is warranted to elucidate the specific mechanisms linking dietary iron to cardiovascular outcomes.
Background:
Nutritional intake can influence major adverse cardiovascular events (MACE). Dietary iron is found in two forms: haem-iron (HI) only found in animal sources and non-haem iron (NHI) present mostly in plant sources.
Objective:
We evaluated the associations between dietary iron intakes with MACE and iron status biomarkers.
Design:
Prospective cohort study.
Setting:
The Concord Health and Ageing in Men Project, Sydney, Australia.
Participants:
539 community-dwelling older Australian men aged 75 years and older.
Methods:
Men underwent nutritional assessment using a validated diet history questionnaire. Entries were converted to food groups and nutrients. The dietary calculation was used to derive HI and NHI intakes from total iron intakes. Analyses of iron intakes with iron status biomarkers were conducted using linear regression, and with MACE and individual endpoints were conducted using Cox regression. Five-point MACE comprised of all-cause mortality, myocardial infarction (MI), congestive cardiac failure (CCF), coronary revascularisation, and/or ischaemic stroke. Four-point MACE included the four endpoints of MI, CCF, coronary revascularisation, and/or ischaemic stroke, and excluded all-cause mortality.
Results:
At a median of 5.3 (4.6 - 6.3) years follow-up, the incidences were: 31.2% (n = 168) five-point MACE, 17.8% (n = 96) four-point MACE excluding all-cause mortality, 20.1% (n = 111) all-cause mortality, 11.3% (n = 61) CCF, and 3.1% (n = 15) coronary revascularisation. In adjusted analyses, higher HI intake (per 1mg increment) was associated with increased five-point MACE (HR: 1.45 [95% CI: 1.16, 1.80, P = .001]), four-point MACE excluding all-cause mortality (HR: 1.64 [95% CI: 1.26, 2.15, P <.001]), all-cause mortality (HR: 1.51 [95% CI: 1.15, 1.99, P = .003]), CCF (HR: 2.08 [95% CI: 1.45, 2.98, P <.001]), and coronary revascularisation (HR: 1.89 [95% CI: 1.15, 3.10, P = .012]). Compared with the bottom tertile of NHI intake, the middle tertile of NHI intake was associated with reduced risk of all-cause mortality (HR: 0.56 [95% CI: 0.33, 0.96, P = .035]). Total iron intake was not associated with MACE and individual endpoints. Dietary iron intakes were not associated with serum iron and haemoglobin.
Conclusion:
Higher haem iron intake was independently associated with increased risks of five-point MACE, four-point MACE excluding all-cause mortality, all-cause mortality, CCF, and coronary revascularisation in older men over 5 years.
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