Hemoglobin levels and new-onset heart failure in the community

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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

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.

Original languageEnglish
Pages (from-to)94-101.e2
Number of pages10
JournalAmerican Heart Journal
Volume169
Issue number1
DOIs
Publication statusPublished - Jan-2015

Keywords

  • FOLLOW-UP
  • CARDIOVASCULAR-DISEASE
  • GENERAL-POPULATION
  • ANEMIA
  • RISK
  • MORTALITY
  • HEMATOCRIT
  • PREDICTION
  • EPIDEMIOLOGY
  • METAANALYSIS

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