Anemia, as indicated by low hemoglobin levels, has been associated with adverse cardiovascular outcomes in patients who have had heart attacks or who have congestive heart failure. Now, new research suggests that this risk also extends to women with limited heart disease.

The findings, which appear in the Journal of the American College of Cardiology, are based on a study of 936 women with chest pain who underwent tests to detect ischemia, or reduced blood flow to the heart.

Most of the women had limited coronary artery disease. Complete data were available for 864 of the women and the average follow-up period was 3.3 years.

Twenty-one percent of the women were anemic, lead author Dr. Christopher B. Arant, from the University of Florida College of Medicine in Gainesville, and colleagues note. Compared with their non-anemic counterparts, anemic women were more likely to be nonwhite and to have a history of high blood pressure, congestive heart failure and diabetes.

Anemic and nonanemic women were no different in terms of coronary artery disease severity. Still, anemic women were more likely to have adverse cardiovascular outcomes and to die from any cause. On further analysis, for each 1 g/dL drop in hemoglobin level below normal the risk of adverse outcomes increased by 20 percent.

The prevalence and prognostic importance of anemia in this population needs to be confirmed, the authors note. Also the underlying disease mechanisms, along with the potential benefits of treating anemia in women with suspected ischemia, need further investigation, the authors note.

SOURCE: Journal of the American College of Cardiology, June 2004.