Iron Deficiency Anemia Correlated With Increased Likelihood of Ischemic Stroke

Iron deficiency anemia (IDA) is associated with an increased risk of ischemic stroke, according to a study published in EJHaem.

Young adult patients aged 15–50 years with IDA were identified from the Explorys national database and categorized into two groups: those with ischemic stroke (Group A; n=36,989) and those without ischemic stroke (Group B; n= 21,765,250). Group A had a higher percentage of essential hypertension, diabetes, dyslipidemia, smoking, and obesity.

Jahnavi Gollamudi, MD, of the University of Cincinnati, and colleagues used a logistic regression model to identify variables that correlated with ischemic stroke. By including an interaction term, they also evaluated the effect modification of IDA on incident stroke by baseline risk factors such as smoking, diabetes, hypertension, dyslipidemia, age, race, and gender.

According to a multivariable analysis, patients with antecedent IDA had a higher risk of stroke after adjusting for age, gender, race, and other risk factors. IDA was associated with 39% increased odds of stroke, independent of the risk factors for stroke (P<0.001).

“Similar results were also reported in a nationwide study done in Taiwan. While these odds may be modest, the high prevalence of IDA in the USA and worldwide may magnify this effect, making IDA-related stroke a public health concern,” wrote Dr. Gollamudi and colleagues.

The researchers also found a “significant statistical interaction” with IDA, age, and non-Caucasian race on ischemic stroke (P<0.05), suggesting that African American patients aged 20–39 years had a higher likelihood of ischemic stroke than Caucasian patients aged 40–50 years with IDA.

“We demonstrate an association between antecedent IDA and ischemic stroke in young adults,” Dr. Gollamudi and colleagues concluded. “Given the high prevalence of IDA in this population, an effective screening strategy is urgently needed to diminish its subsequent complications.”

The researchers noted the study’s retrospective nature as a major limitation, as well as the inability to determine ferritin values for every patient. Additionally, the study was not designed to evaluate the effects of socioeconomic risk factors on treatment and mortality related to IDA and stroke.