Date Published: 
Friday, 16 May, 2014

Prior iron deficiency anaemia is a risk factor for ischaemic stroke, according to new study

Professor Jorge Toblli

There is a significant association between prior iron deficiency anaemia and ischaemic stroke, data indicate. Researchers recommend that patients found to have iron deficiency anaemia be surveyed and managed for the possible underlying bleeding source and/or iron deficiency status in order to reduce the risk of subsequent ischaemic stroke. The authors recommend that the casual relationship between iron deficiency anaemia and ischaemic stroke be further investigated.

Iron deficiency anaemia is estimated to account for approximately half of all anaemia cases worldwide. However, as most patients with anaemia are asymptomatic, the true incidence of iron deficiency anaemia may be higher than currently reported. Most studies to date have focused on the effects of iron deficiency anaemia after or during cardiovascular disease. The purpose of this case-control study was to evaluate the association of prior iron deficiency anaemia with ischaemic stroke.

Chang and colleagues investigated the relationship between iron deficiency anaemia and ischaemic stroke in a large group of individuals (51,093 stroke patients and 153,279 controls). Results showed that 3,685 study subjects (1.81%) had been diagnosed with iron deficiency anaemia prior to the date of analysis; of those subjects, 1,268 (2.48%) were stroke patients and 2,417 (1.58%) were controls (p<0.001). Conditional logistic regression showed that the odds ratio of having previously received a diagnosis of iron deficiency anaemia among stroke patients, compared to controls, was 1.49 (95% CI: 1.39–1.60; p<0.01).

The study results indicate that there is a significant association between prior iron deficiency anaemia and ischaemic stroke, which may be attributed to compromised oxygen delivery to the tissues resulting from reduced haemoglobin levels. Another possible explanation suggested by the authors is the occurrence of secondary thrombocytosis resulting from iron deficiency.

The authors recommend that patients found to have iron deficiency anaemia should be more aggressively surveyed and managed for the possible underlying bleeding source and/or iron status in order to reduce the risk of subsequent ischaemic stroke. Stroke is a leading cause of long-term severe disability resulting in a substantial economic burden on healthcare systems worldwide. Therefore, information on potential therapeutic strategies in order to reduce risk factors is of high importance.

The full article can be found in the December 2013 issue of PLOS One. For further information on the link between cardiovascular disease and iron deficiency please click here.

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