Can Anemia Damage Your Heart?

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Anemia is a condition in which red blood cells, which carry oxygen from the lungs to other parts of the body, is of abnormally low levels. So your heart needs to work harder, pumping more blood, to help your tissues and organs get sufficient oxygen. This causes abnormally fast (tachycardia) and irregular (arrhythmia) heartbeats; the size of the heart can also increase (cardiomegaly) to accommodate the volume of blood that needs to be pumped out. The result is often heart failure. Anemia can also have a dangerous triangular relationship with heart and kidney disease, where the three conditions feed off each other in a condition called cardio-renal anemia (CRA) syndrome. The good news is that it can be treated with supplements and medication. A diet rich in iron, vitamin B12, vitamin C, and folic acid can help tackle anemia.

Heart disease is the leading cause of death in the US, accounting for one in every four deaths. High cholesterol, high blood pressure, and smoking are often clear offenders that increase the risk of heart disease.1 But did you also know that anemia can damage your heart?

Anemia is a condition in which the red blood cells in your body are of abnormally low levels. Red blood cells contain a protein called hemoglobin that is rich in iron and which helps to carry oxygen from the lungs to other parts of the body. Lack of sufficient oxygen can leave you weak and fatigued. You may also experience labored breathing, dizziness, and headaches. Severe anemia can damage your brain, heart, and other organs.

What Causes Anemia?

Anemia sets in when your body doesn’t produce enough red blood cells or destroys too many red blood cells. Poor diet, pregnancy, hormonal imbalances, and diseases like cancer can result in insufficient red blood cell production in the body, while a diseased or enlarged spleen and hereditary diseases like thalassemias and sickle cell anemia can destroy red blood cells in large numbers. Anemia is most commonly caused by blood loss, which may occur due to trauma, surgery, heavy menses, or bleeding in the urinary or digestive tract.2

Although anemia can occur across ages, genders, and ethnic groups, some people might be more vulnerable.

  • Blood loss during menstruation ups the risk of anemia in women. Moreover, when you’re pregnant, for the first six months, your body generates more plasma (the fluid part of blood) than red blood cells. This can dilute the blood and cause anemia. You can also get anemia when you’re pregnant if your iron and folic acid levels are low.
  • Babies can be vulnerable if they’re born prematurely. Also, the first year is crucial – babies who are given formula that hasn’t been enriched with iron or are only given breast milk may often be deficient in iron as early as six months. Children between the ages of one and two who don’t have iron-rich foods can also get anemia, especially if they have a lot of milk, which reduces the intake of iron-rich food.
  • Older people are also at a higher risk of developing anemia. This could be a result of age-related nutritional deficiencies or chronic diseases such as that of the heart or kidney.3

How Does Anemia Affect The Heart?

Anemia and the heart share an uneasy equation. Almost 50% of those who have congestive heart failure are anemic.4 In people with severe heart failure, anemia can up the risk of death, which increases in proportion to the severity of anemia.5

So how does anemia disrupt the health of your heart? The low oxygen levels in your blood, as a result of anemia, mean that your heart needs to work harder and pump more blood to give your tissues and organs sufficient oxygen. So the heart beats faster and a larger volume of oxygen-rich blood is pumped out by the left ventricle with each beat. This can cause abnormally fast (tachycardia) and irregular heartbeats (arrhythmia). The size of the heart (specifically the left ventricle) can also increase (cardiomegaly) to accommodate the volume of blood that needs to be pumped. The result is often heart failure. Several studies evaluating cardiac function in subjects with anemia have found a startling correlation.6 For instance, one study by Alvares et al. found that 27% of participants (comprising adults and adolescents) with very low hemoglobin levels (an average of 5 g/dL) had congestive heart failure. On the upside, ventricular function was found to improve when hemoglobin levels rose as a result of iron therapy.7

Anemia can also have a dangerous triangular relationship with heart and kidney disease through a phenomenon called cardio-renal anemia (CRA) syndrome. What happens is that either kidney disease or heart disease reduces the secretion of the hormone erythropoietin, which has a role in stimulating the production of red blood cells. The resultant anemia, in turn, worsens cardiac function. To complicate things further, both the anemia and the heart disease also cause damage to the kidneys.8

What Can You Do About Anemia?

Treatment for anemia depends on what’s causing it. For instance, your doctor may prescribe synthetic erythropoietin to encourage the production of red blood cells or hormones to stop excessive menstrual bleeding. Blood and marrow stem cell transplants may be needed in the case of sickle cell anemia or thalassemias to replace defective stem cells. Surgery may stop blood loss in some cases – for example, if you’re bleeding due to a stomach ulcer.

Anemia caused by nutritional deficiencies is easier to treat. Your doctor may prescribe supplements to address this. Also, make sure that you eat a well-balanced diet to stay healthy. You might want to pay attention to these elements in particular:

  • Iron is required to make hemoglobin. Red meat, chicken, pork, and fish are good sources of iron. Green leafy vegetables like spinach, beans, lentils, peas, and tofu also contain iron; however, it’s more difficult for the body to absorb the iron present in them.
  • Vitamin C plays a role in the absorption of iron. Fruits and vegetables can be great sources of vitamin C. Tangerines, oranges, strawberries, brussels sprouts, broccoli, and tomatoes can help you get your daily fix.
  • Vitamin B12 deficiency can also cause anemia. Having dairy products, eggs, and meat can help you get enough of this vital vitamin.
  • Folic Acid, a form of vitamin B, helps create and maintain new cells. Eggs, bananas, green leafy vegetables, and beef liver contain folic acid.9

References   [ + ]

1. Heart Disease, Centers for Disease Control and Prevention
2. What Causes Anemia? National Institutes Of Health.
3. Who Is at Risk for Anemia? National Institutes Of Health.2012.
4. Silverberg, Donald S., Dov Wexler, and Adrian Iaina. “The importance of anemia and its correction in the management of severe congestive heart failure.” European Journal of Heart Failure 4, no. 6 (2002): 681-686.
5. Mozaffarian, Dariush, Regina Nye, and Wayne C. Levy. “Anemia predicts mortality in severe heart failure: the prospective randomized amlodipine survival evaluation (PRAISE).” Journal of the American College of Cardiology 41, no. 11 (2003): 1933-1939.
6. Hegde, Nikita, Michael W. Rich, and Charina Gayomali. “The cardiomyopathy of iron deficiency.” Texas Heart Institute Journal 33, no. 3 (2006).
7. Alvares, J. F., J. L. Oak, and A. V. Pathare. “Evaluation of cardiac function in iron deficiency anemia before and after total dose iron therapy.” The Journal of the Association of Physicians of India 48, no. 2 (2000): 204-206.
8. Silverberg, Donald S., Dov Wexler, and Adrian Iaina. “The role of anemia in the progression of congestive heart failure. Is there a place for erythropoietin and intravenous iron?.” Journal of nephrology 17, no. 6 (2003): 749-761.
9. How Is Anemia Treated? National Institutes Of Health.