Hemoglobin levels and new-onset heart failure in the community.

Abstract

BACKGROUND:

In established cardiovascular disease and heart failure (HF), low hemoglobin levels are associated with unfavorable outcome. Whether hemoglobin levels are associated with the development of new-onset HF in the population is unclear. This study sought to investigate the relationship between hemoglobin levels and development of new-onset HF in the community.

METHODS:

In 6,744 patients from PREVEND, a prospective, community-based, cohort study, we analyzed the relationship between hemoglobin levels and the risk of new-onset HF.

RESULTS:

Mean age (±SD) was 53 ± 12 years, 49.8% was male, and mean hemoglobin level was 13.7 ± 1.2 g/dL. During a median follow-up of 8.3 years (interquartile range 7.8-8.9), 217 subjects (3.2%) were newly diagnosed with HF. The association between hemoglobin levels and the risk for new-onset HF was U shaped (P< .001), remaining significant after full adjustment in a multivariable model with established cardiovascular risk factors (P= .015). Furthermore, a increased annual HF incidence was already observed in subjects with high-normal hemoglobin levels (men >16 g/dL or women >15 g/dL; P= .041), whereas on the other side of the distribution, only severe anemia (men <11 g/dL or women <10 g/dL; P= .018) was associated with a higher annual incidence.

CONCLUSIONS:

The impact of hemoglobin level on the risk of new-onset HF in the community is best described as U shaped. Interestingly, higher hemoglobin levels, already within the high-reference range, are associated with an increased incidence. This in contrast to anemia, where a higher annual HF incidence was only observed for severe anemia.

• Authors: Ijsbrand T Klip, Douwe Postmus, Adriaan A Voors, Frank P J Brouwers, Ron T Gansevoort, Stephan J L Bakker, Hans L Hillege, Rudolf A de Boer, Pim van der Harst, Wiek H van Gilst, Dirk J van Veldhuisen, Peter van der Meer
• Journal: American heart journal (Am Heart J) Vol. 169 Issue 1 Pg. 94-101.e2 (Jan 2015) ISSN: 1097-6744 [Electronic] United States
• PMID: 25497253 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Hemoglobins

Topics

• Adult
• Aged
• Cohort Studies
• Female
• Heart Failure (blood, epidemiology)
• Hemoglobins (analysis)
• Humans
• Incidence
• Male
• Middle Aged
• Risk Factors