We investigated whether the presence of anemia is a risk factor for cardiovascular
disease (CVD) outcomes in the general population.
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.
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.
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.
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.