International Health News

Iron accelerates atherosclerosis

INNSBRUCK, AUSTRIA. A team of Austrian and Italian medical researchers report new evidence implicating iron in the promotion of atherosclerosis. Their study involved a random sample of 826 men and women between the ages of 40 and 79 years who were resident of Bruneck in the Italian province of Bolzano. The researchers measured the correlation between iron stores (serum ferritin) and the progression of carotid atherosclerosis (measured via ultrasound) over a five-year follow-up period (1990-1995). They found a strong correlation between serum ferritin concentrations and the progression of atherosclerosis even when adjusting for other risk factors. They confirmed that the incidence of atherosclerosis and cardiovascular disease in premenopausal women is much less than that among men between the ages of 40 and 59 years (1.3/100 person-years vs 4.4/100 person-years). They also noted a gradual increase in the incidence of atherosclerosis among postmenopausal women particularly among those who have undergone a hysterectomy. The overall incidence among postmenopausal women was 3.4/100 person-years in the case of natural menopause and 4.0/100 person-years for surgical menopause (hysterectomy).

The effect of serum ferritin level on the incidence of atherosclerosis was, however, significantly stronger than the effect of sex and menopausal stage. Using a cut-off point of 50 micrograms/liter the researchers concluded that men with a level below the cut-off point had an incident risk of 0.3/100 person- years versus 4.8/100 person-years for men with a serum ferritin level equal to or greater than 50 micrograms/liter. The corresponding figures for premenopausal women were 0.2 and 4.5/100 person-years, for postmenopausal women with natural menopause 1.6 vs 4.4, and for women who had undergone a hysterectomy the incident risk was 1.2 at low ferritin levels and 5.1/100 person-years at levels above 50 micrograms/liter.

Other researchers have found that blood donors and men who have experienced acute or chronic bleeding events have a lower risk of heart disease. The research team confirmed this finding by observing that subjects who had lost blood for some reason or other significantly slowed the progression of their atherosclerosis. The researchers speculate that iron promotes atherosclerosis through its role in lipid peroxidation, but cautions that more work is needed before general recommendations can be made to lower iron stores (to the level of premenopausal women) as a means of preventing both the onset and progression of atherosclerosis.
Kiechl, Stefan, et al. Body iron stores and the risk of carotid atherosclerosis. Circulation, Vol. 96, November 18, 1997, pp. 3300-07
Gillum, Richard F. Body iron stores and atherosclerosis. Circulation, Vol. 96, November 18, 1997, pp. 3261-63 (editorial)

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