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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.
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