DAVID FELDMAN, M.D., Ph.D., FACC
director of heart failure and cardiac transplantation
The Ohio State University

Renee, California, USA

Can you tell me how iron intake and blood levels relate to heart disease in older men? I know that women don't have issues with excess iron until after menopause. Do men accumulate more iron because they have no way to eliminate excessive iron stores? Do their higher iron levels increase the risk of arteriosclerosis?

David Feldman
director of heart failure and cardiac transplantation,
Davis Heart & Lung Institute,
The Ohio State University
(former HHMI physician postdoctoral fellow)

The answer to all your questions, Renee, is yes. Men consume a lot of iron, and under some circumstances their bodies accumulate this iron in excess. This can cause disease of the heart and other organs.

Research has demonstrated a linear correlation between serum iron levels and the incidence of coronary artery disease. In addition, men in general do not need any supplementation because they get an adequate supply in the typical American diet. Take a look at vitamins marketed for men at your grocery or drugstore: they do not contain supplemental iron because it is unnecessary. Men in general have a minimal requirement for dietary iron; too much extra becomes problematic because over time it can accumulate in solid organs. Both men and women can store so much iron that they develop a disease called hemochromotosis. Women generally keep iron levels in equipoise with menstruation until they reach menopause, and this accounts for the delayed onset of excess iron in women.

Hemochromatosis is an infiltrative disease that primarily affects the liver and the heart, although other organs, such as the pancreas, are also affected. It can be treated with phlebotomy (removing some blood); extreme cases sometimes require a heart-liver transplant. With advanced disease, patients may die of congestive heart failure, electrical disturbances, or liver failure.

08/06/08 23:55