Медицинские услуги
© 2017-2021 Сайт «БЕЛМЕД.БАЙ», info@belmed.by
Arch Intern Med 2005;165:2187-2189,2214-2220
Comment from Reuters Health (New York) Oct 25
Either very high or very low levels of hemoglobin are independently associated with an increased risk of mortality in older individuals, investigators report.
Dr. Mary Cushman, from the University of Vermont in Colchester and her colleagues analyzed data from the Cardiovascular Health Study, a prospective, observational study of risk factors in 5797 community-dwelling adults ages 65 years or older. They report their findings in the Archives of Internal Medicine for October 24.
During a median 11.2 years of follow-up, mortality was higher among patients in the lowest quintile of hemoglobin concentration (49%), and in the fifth quintile (41%).
Based on World Health Organization criteria for anemia (hemoglobin < 13 g/dL in men and < 12 g/dL in women), the age-, race- and sex-adjusted hazard ratio for mortality was 1.57.
"This result suggests that a hemoglobin concentration at the upper range of normal (> 15.6 g/dL for men and > 14.4 /dL for women) may confer an increased risk of mortality," the authors note. They suggest that higher hemoglobin concentrations may lead to increased blood viscosity, blood pressure, and dialysis-access thrombolysis.
In a related editorial, Dr. Jerry L. Spivak comments that anemia in the elderly is often caused by conditions such as chronic renal insufficiency, cancer or bone marrow failure, "most of which defy correction."
"What remains to be determined," suggests Dr. Spivak, from Johns Hopkins University School of Medicine, Baltimore, "is whether pharmacologic correction of anemia in the elderly with recombinant erythropoietin can slow disease progression, reduce morbidity, improve quality of life, and prolong survival, and whether there is a favorable cost-benefit ratio to society for such improvements."