Hemoglobin and atherosclerosis in patients with manifest arterial disease. The SMART-study.
BACKGROUND
Decreased hemoglobin levels are known to be associated with an increased risk of coronary mortality and morbidity. This is largely thought to result from the development of left ventricular hypertrophy. Similar remodeling mechanisms of the vessel wall that may result in atherosclerosis are likely to be present. We studied whether hemoglobin levels are related to different vascular indicators of atherosclerosis.


RESULTS
This cross-sectional study was performed in the first consecutive 2514 patients with manifest arterial disease enrolled in the SMART-study (Second Manifestations of ARTerial disease). The relation of hemoglobin levels with common carotid IMT (CIMT), presence of a>/=50% internal carotid artery stenosis (ICAS) and prevalent peripheral arterial disease (PAD) was assessed with linear and logistic regression analyses. Each mmol/l increase in hemoglobin was associated with a lower CIMT (-0.03 mm [95% CI: -0.04; -0.01]) and a lower prevalence of >/=50% ICAS (odds ratio: 0.84 [95% CI: 0.73; 0.97]) after adjustment for age, gender and potential confounders. Hemoglobin was not related to prevalence of peripheral arterial disease (1.02 [95% CI: 0.89; 1.16]).


CONCLUSIONS
This study shows that in patients with manifest arterial disease, increasing hemoglobin levels are associated with reduced severity of atherosclerosis.
Dijk
J M
JM
Julius Center for Health Sciences and Primary Care, University, Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Wangge
G
G
Graaf
Y van der
Yv
Bots
M L
ML
Grobbee
D E
DE
Algra
A
A
D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology; D016893:Carotid Stenosis / Q000097:blood* / Q000150:complications; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000150:complications; D012044:Regression Analysis; D012737:Sex Factors; D017539:Tunica Intima / Q000473:pathology*
D006454:Hemoglobins