Low blood count ups death risk in elderly people

NEW YORK, 28 july 2009-- New research indicates that low red blood cell blood counts, regardless of other diseases that might be present, is a risk factor for death in very elderly individuals. In the study, anemia was associated with a twofold increased risk of death during follow-up.

Prior reports have linked low red blood cell counts, also known as anemia, with death, but it was unclear if this was simply due to the chronic diseases that often accompany anemia or the anemia itself, Wendy P. J. den Elzen and colleagues, from Leiden University Medical Center, the Netherlands, note in the Canadian Medical Association Journal.

Red blood cells carry oxygen around the bloodstream, from the lungs to the body's tissues.

The researchers analyzed data from 562 subjects who were at least 85 years of age. Just more than a quarter of subjects had anemia at baseline, and another quarter developed it during the five years of follow-up.

Anemia was linked to an increased risk of death during follow-up, and was also associated with increased difficulties with activities of daily living.

In an accompanying editorial, Dr. A. Mark Clarfield, from McGill University, Montreal, and Ora Paltiel, from Hadassah-Hebrew University, Jerusalem, comment that further research is needed to determine if anemia actually causes increased mortality and to determine if treating anemia in very elderly people improves survival and functional outcomes.

SOURCE: Canadian Medical Association Journal, July 27th online issue, 2009.

Anemia associated with greater risk of death in heart disease patients

New study has found that anemia in patients with chronic heart failure is associated with a increased risk of death

Wagga Wagga, Australia -29 may 2009– A new study appearing in Congestive Heart Failure has found that the presence of anemia in patients with chronic heart failure is associated with a significantly increased risk of death. The findings also show that anemia is associated with a poorer degree of left ventricular function and a lower left ventricular ejection fraction, an objective measure of cardiac function.

Heart failure is a common and serious chronic illness. A large number of patients with heart failure also have anemia, which is most likely a complication from poor heart function. The aim of this study was to assess the impact of anemia on the clinical outcomes of chronic heart failure (CHF) by a meta-analysis and systemic review of published literature. A total of 97,699 patients with CHF were identified from the published studies. From a collective analysis, researchers found that when anemia occurs, it worsens patient prognosis, making them more likely to be hospitalized or die from heart failure.

"Health professionals may need to improve current practices to better treat anemia in patients with chronic heart failure," says Dr. Lexin Wang, M.D., Ph.D., Head of the Cardiovascular Group at Charles Sturt University and co-author of the study.

Even with contemporary medical treatment, the mortality rate from chronic heart failure is still very high, reaching 40 percent in very sick patients. Given the clear association between anemia and the mortality rate and hospitalization rate, optimal treatment of anemia, on top of other heart-failure-specific therapies, may reduce the rate of mortality and further improve patient's prognosis.

Co-Editor's in Chief, Drs. John Strobeck and Marc Silver are feel that "this publication by Dr. Wang and collaborators give some perspective to nearly a decade of interest on the relationship and role of anemia in patients with chronic heart failure.

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This study is published in Congestive Heart Failure. Media wishing to receive a PDF of this article may contact medicalnews@bos.blackwellpublishing.net

Anemia in the elderly: how should we define it, when does it matter, and what can be done?

Steensma DP, Tefferi A.
Division of Hematology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (steensma.david@mayo.edu).
Anemia signifies an underlying disease and is associated with poor clinical outcomes. In elderly patients, in whom anemia has a high prevalence (greater than 10 percent), neither the hemoglobin threshold for concern nor the identity of the anemia-causing disease is easily established. This is an important shortfall, because even mild anemia can compromise patient well-being and survival, regardless of the underlying cause. This review discusses definitions of "normal" hemoglobin levels in adults, common causes of anemia in people aged 65 years and older (eg, nutritional deficiency, renal insufficiency, inflammatory disorders, and myelodysplastic syndrome), and potential consequences of anemia in elderly patients (eg, poorer cognitive status, increased frailty, and an elevated risk of hospitalization and of complications during hospitalization). We also outline a practical initial diagnostic approach that helps determine appropriate treatment, and we weigh therapeutic options in light of new safety concerns regarding erythropoiesis-stimulating agents.