Skip to main content

Iron and Heart Disease

A Review of The Epidemiologic Data

  • Chapter

Part of the book series: Nutrition ◊ and ◊ Health ((NH))

Abstract

In 1981 Jerome Sullivan (1) proposed a new theory to explain the differences in coronary heart disease (CHD) incidence and mortality between men and women. He noticed that as men and women age the gaps between them in heart disease incidence and in body iron stores both decrease (2,3). Lower stores of iron levels in women are mostly a result of menstrual blood loss and with menopause the differences in iron stores decrease. As a result, he theorized that body iron stores are directly or positively related to CHD risk, i.e., the higher your body iron stores the greater your CHD risk. Until the publication of results from Finland by Salonen et al. (4) showing a positive relationship between serum ferritin levels, a measure of body iron stores, and the risk of heart attack in men the hypothesis was largely ignored. Since then, however, there has been an almost explosive interest in the relationship of body iron stores to the risk of heart disease.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sullivan JL. Iron and the sex difference in heart disease risk. Lancet 1981; 1:1293, 1294.

    Google Scholar 

  2. Sullivan JL. The iron paradigm of ischemic heart disease. Am Heart J 1989; 117:1177–1188.

    Article  CAS  Google Scholar 

  3. Sullivan JL. The sex difference in ischemic heart disease. Perspect Biol Med 1983; 26:657–671.

    CAS  Google Scholar 

  4. Salonen JT, Nyyssonen K, Korpela H, Tuomilehto J, Seppänen R, Salonen R. High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation 1992; 86:803–811.

    Article  CAS  Google Scholar 

  5. Bottiger L-E, Carlson LA. Risk factors for ischemic vascular death for men in the Stockholm Prospective Study. Atherosclerosis 1980; 36:398–408.

    Article  Google Scholar 

  6. Paul 0, Lepper MH, Phelan WH, et al. A longitudinal study of coronary heart disease. Circulation 1963; 28:20–31.

    Article  CAS  Google Scholar 

  7. Truett J, Cornfield J, Kannel W. A multivariate analysis of risk of coronary heart disease in Framingham. J Chronic Dis 1967; 20:511–524.

    Article  CAS  Google Scholar 

  8. Carter C, McGee D, Reed D, Yano K, Stemmermann G. Hematocrit and the risk of coronary heart disease: the Honolulu Heart Program. Ann Heart J 1983; 105:674–679.

    Article  CAS  Google Scholar 

  9. Cullen KJ, Stenhouse NS, Wearne KL. Raised haemoglobin and risk of cardiovascular disease. Lancet 1981; 2:1288, 1289.

    Google Scholar 

  10. Sorlie PD, Garcia-Palmieri MR, Costas R Jr, Havlik RJ. Hematocrit and risk of coronary heart disease: the Puerto Rico Heart Health Program. Am Heart J 1981; 101:456–461.

    Article  CAS  Google Scholar 

  11. Mayer GA. Hematocrit and coronary heart disease. Can MedAssoc J 1965; 180:63–65.

    Google Scholar 

  12. Liao Y, Cooper RS, McGee DL. Iron status and coronary heart disease: negative findings from the NHANES I Epidemiologic Follow-up Study. Am J Epidemiol 1994; 139:704–712.

    CAS  Google Scholar 

  13. Graham S. Results of case-control studies of diet and cancer in Buffalo, New York. Cancer Res 1983; 2409s-2413s.

    Google Scholar 

  14. Ziegler R. Vegetables, fruits and carotenoids and the risk of cancer. Am J Clin Nutr 1991; 53:251 s-259s.

    Google Scholar 

  15. Diplock AT. Antioxidant nutrients and disease prevention: an overview. Am J Clin Nutr 1991; 53:189s-193s.

    Google Scholar 

  16. Stevens RG, Jones DY, Micozzi MS, Taylor PR. Body iron stores and the risk of cancer. New Engl J Med 1988; 319:1047–1052.

    Article  CAS  Google Scholar 

  17. Stevens RG, Beasley RP, Blumberg BS. Iron-binding proteins and risk of cancer in Taiwan. J Natl Cancer Inst 1986; 76:605–610.

    CAS  Google Scholar 

  18. Selby JV, Friedman GD. Epidemiologic evidence of an association between body iron stores and risk of cancer. Int J Cancer 1988; 41:677–682.

    Article  CAS  Google Scholar 

  19. Merk K, Mattsson B, Mattsson A, Holm G, Gullbring B, Björkholm M. The incidence of cancer among blood donors. Int J Epidemiol 1990; 19:505–509.

    Article  CAS  Google Scholar 

  20. Korn EL, Graubard BI. Epidemiologic studies utilizing surveys: accounting for the sampling design. Am J Public Health 1991; 81:1166–1173.

    Article  CAS  Google Scholar 

  21. Stevens RG, Graubard BI, Micozzi MS, Nershi K, Blumberg BS. Moderate elevation of body iron level and increased risk of cancer occurrence and death. Int J Cancer 1994; 56:364–369.

    Article  CAS  Google Scholar 

  22. Knekt P, Reunanen A, Takkunen H, Aromaa A, Heliövaara M, Hakulinen T. Body iron stores and risk of cancer. Int J Cancer 1994; 56:379–382.

    Article  CAS  Google Scholar 

  23. Nelson RL, Davis FG, Sutter E, Sobin LH, Kikendall JW, Bowen P. Body iron stores and risk of colonic neoplasia. J Natl Cancer Inst 1994; 86:455–460.

    Article  CAS  Google Scholar 

  24. Jha P, Flather M, Lonn E, Farkouh M, Yusuf S. The antioxidant nutrients and cardiovascular disease. A critical review of epidemiologic and clinical trial data. Ann Intern Med 1995; 123:860–872.

    CAS  Google Scholar 

  25. Chalmers TC. Antioxidants and cardiovascular disease: why do we still not have the answers. Ann Intern Med 1995; 123:887.

    CAS  Google Scholar 

  26. Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL. Beyond cholesterol. Modifications of lowdensity lipoprotein that increase its atherogenicity. New Engl J Med 1989; 320:915–924.

    Article  CAS  Google Scholar 

  27. Esterbaurer H, Gebicki J, Phul H, Jurgens G. The role of lipid peroxidation and antioxidants in oxidative modification of LDL. J Free Rad Biol Med 1992; 13:341–390.

    Article  Google Scholar 

  28. Smith C, Mitchinson MJ, Auroma OI, Halliwell B. Stimulation of lipid peroxidation and hydroxyl-radical generation by the contents of human atherosclerotic lesions. Biochem J 1992; 286:901–905.

    CAS  Google Scholar 

  29. McCord JM. Is iron sufficiency a risk factor for ischemic heart disease. Circulation 1991; 83:1112–1114.

    Article  CAS  Google Scholar 

  30. Expert Scientific Working Group. Summary of a report on assessment of the iron nutritional status of the United States population. Am J Clin Nutr 1985; 42:1318–1330.

    Google Scholar 

  31. Bothwell T, Charlton R, Cook J, Finch C. Iron Metabolism in Man. Oxford, England: Blackwell Scientific, 1979.

    Google Scholar 

  32. Herbert V. Everyone should be tested for iron disorders. J Am Diet Assoc 1992; 92:1502–1509.

    CAS  Google Scholar 

  33. Custer EM, Finch CA, Sobel RE, Zettner A. Populations norms for serum ferritin. J Lab Clin Med 1995; 126:88–94.

    CAS  Google Scholar 

  34. Yip R, Dallman PR. The roles of inflammation and iron deficiency as causes of anemia. Am J Clin Nutr 1988; 48:1295–1300.

    CAS  Google Scholar 

  35. Birgegård G, Hällgren R, Venge P, Wide L. Serum ferritin during inflammation. A study on myocardial infarction. Acta Med Scan 1979; 206:361–366.

    Article  Google Scholar 

  36. Griffiths JD, Campbell LJ, Woodruff IW, Cruickshank D, Mathews YB, Hunt D, Campbell DG, Cowling DC. Acute changes in iron metabolism following myocardial infarction. Am J Clin Pathol 1985; 84:649–654.

    CAS  Google Scholar 

  37. van der Schouw YT, van der Veek PMWC, Kok FJ, Koster JF, Schouten EG, Hofman A. Free Radical Biol Med 1990; 8:47–53.

    Article  Google Scholar 

  38. Lilienfeld AM, Lilienfeld DE. Foundations of Epidemiology. 2nd Ed. New York: Oxford University Press, 1980.

    Google Scholar 

  39. Salonen JT, Nyyssönen K, Salonen R. Body iron stores and the risk of coronary heart disease. (Letter). New Engl J Med 1994; 331:1159.

    Article  CAS  Google Scholar 

  40. Weiss G, Fuchs D, Wachter H. High stored iron levels and the risk of myocardial infarction. (Letter). Circulation 1993; 87:1425.

    Article  CAS  Google Scholar 

  41. MacDonald HB. High stored iron levels are associated with excess risk of myocardial infarction in Eastern Finnish Men. (Letter). Circulation 1993: 87:2063.

    Google Scholar 

  42. Salonen JT, Nyyssonen K, Korpela H, Salonen R, Tuomilehto J, Seppänen R. High storediron levels and the risk of myocardial infarction. (Reply) Circulation 1993; 87:1425,1426.

    Google Scholar 

  43. Salonen JT, Nyyssonen K, Korpela H, Salonen R, Tuomilehto J, Seppänen R. High stored iron levels are associated with excess risk of myocardial infarction in Eastern Finnish Men. (Reply). Circulation 1993; 87:2063,2064.

    Google Scholar 

  44. Stampfer MJ, Grodstein F, Rosenberg I, Willett W, Hennekens C. A prospective study of plasma ferritin and risk of myocardial infarction in US physicians. Circulation 1993;87:688 (abstract).

    Google Scholar 

  45. Magnusson MK, Sigfusson N, Sigvaldason H, Johannesson GM, Magnusson S, Thorgeirsson G. Low ironbinding capacity as a risk factor for myocardial infarction. Circulation 1994; 89:102–108.

    Article  CAS  Google Scholar 

  46. Frey GH, Krider DW. Serum ferritin and myocardial infarct. WV Med J 1994; 90:13–15.

    CAS  Google Scholar 

  47. Dormandy TL. Free-radical oxidation and antioxidants. Lancet 1978; 1:647–650.

    Article  CAS  Google Scholar 

  48. Sempos CT, Looker AC, Gillum RF, Makuc DM. Body iron stores and the risk of coronary heart disease. New Engl J Med 1994; 330:1119–1124.

    Article  CAS  Google Scholar 

  49. Reunanen A, Takkunen H, Knekt P, Sappänen R, Aromaa A. Body iron stores, dietary iron intake and coronary heart disease mortality. J Intern Med 1995; 238:223–230.

    Article  CAS  Google Scholar 

  50. Baer DM, Tekawa IS, Hurley LB. Iron stores are not associated with acute myocardial infarction. Circulation 1994; 89:2915–2918.

    Article  CAS  Google Scholar 

  51. van Asperen IA, Feskensens EJM, Bowels CH, Kromhout D. Body iron stores and mortality due to cancer and ischemic heart disease: a 17-year follow-up study of elderly men and women. Int J Epidemiol 1995; 24:665–670.

    Article  CAS  Google Scholar 

  52. Morrison HI, Semenciw RM, Mao Y, Wigle DT. Serum iron and fatal acute myocardial infarction. Epidemiology 1994; 5:243–246.

    Article  CAS  Google Scholar 

  53. Takkunen H, Reunanen A, Knekt P, Aromaa A. Body iron stores and the risk of cancer (Letter). New Engl J Med 1989; 320:1013,1014.

    Google Scholar 

  54. Ascherio A, Willett WC, Rimm EB, Giovannucci EL, Stampfer MJ. Dietary iron and risk of coronary heart disease among men. Circulation 1994; 89:969–974.

    Article  CAS  Google Scholar 

  55. Aronow WS. Serum ferritin is not a risk factor for coronary artery disease in men and women aged ≥ 62 years. Am J Cardiol 1993; 72:347–348.

    Article  CAS  Google Scholar 

  56. Solymoss BC, Marcil M, Gilfix BM, Gelinas F, Poitras AM, Campeau L. The place of ferritin among risk factors associated with coronary artery disease. Coronary Artery Dis 1994; 5:231–235.

    Article  CAS  Google Scholar 

  57. Rauramaa R, Väisänen S, Mercuri M, Rankinen T, Penttila I, Bond MG. Association of risk factors and body iron status to carotid atherosclerosis in middle-aged Eastern Finnish men. Eur. Heart J 1994; 15:1020–1027.

    Google Scholar 

  58. Kiechl S, Aichner F, Gerstenbrand F, Egger G, Mair A, Rungger G, Spogler F, Jarosch E, Oberhollenzer F, Willeit J. Body iron stores and presence of carotid atherosclerosis. Results from the Bruneck Study. Arteriosclerosis Thromb 1994; 14:1625–1630.

    Article  CAS  Google Scholar 

  59. Moore M, Folsom AR, Barnes RW, Eckfeldt JH. No association between serum ferritin and asymptomatic carotid atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 1995; 141:719–723.

    Google Scholar 

  60. Miller M, Hutchins GM. Hemochromatosis, multiorgan hemosiderosis, and coronary heart disease. JAMA 1994: 272:231–233.

    Article  CAS  Google Scholar 

  61. Lauffer RB. Iron stores and the international variation in mortality from coronary artery disease. Med Hypotheses 1990; 35:96–102.

    Article  Google Scholar 

  62. Keys A. Coronary heart disease in seven countries. Circulation 1970; 41:1–245.

    Article  Google Scholar 

  63. McGill HC, Jr. (ed.). Geographic Pathology of Atherosclerosis. Baltimore, MD; Williams & Wilkins, 1968

    Google Scholar 

  64. Sullivan JL. Stored iron and ischemic heart disease. Empirical support for the new paradigm. Circulation 1992; 86: 1036,1037.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Sempos, C.T., Gillum, R.F., Looker, A.C. (1997). Iron and Heart Disease. In: Bendich, A., Deckelbaum, R.J. (eds) Preventive Nutrition. Nutrition ◊ and ◊ Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4757-6242-6_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-6242-6_10

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-6244-0

  • Online ISBN: 978-1-4757-6242-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics