What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease (n=14410). Intervention: Anemia vs. No anemia. Primary outcome: Cardiovascular disease (CVD) events (HR 1.41, 95% CI 1.01-1.95).

What question did this study set out to answer?

To determine whether anemia is an independent risk factor for incident cardiovascular disease events in the general community population.

April 25, 2026Journal of the American College of Cardiology

Anemia as a risk factor for cardiovascular disease in the atherosclerosis risk in communities (aric) study

Q: What are the key findings of this study?

Anemia was independently associated with an increased risk of cardiovascular disease events (HR 1.41; 95% CI 1.01-1.95) in a community cohort of adults aged 45 to 64 years.

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Key result

Anemia is linked to a ~41% increased risk of CVD events in middle-aged adults.

HR 1.41
95% CI 1.01-1.95
n=14,410

Why the study?

Chronic anemia is a risk factor for cardiovascular disease outcomes in patients with kidney disease and heart failure but has not been evaluated as a risk factor in the general population.

Is the presence of anemia an independent risk factor for cardiovascular disease outcomes in the general population?

Population

14,410 subjects aged 45-64 years without CVD at baseline in the ARIC cohort

Comparison

Presence of anemia vs absence of anemia

Design

Cohort study

Follow-up

Average 6.1 years

Authors

MSMark J. SarnakPreventive Cardiology HTHocine TighiouartHeart Failure & Transplant GMGuruprasad ManjunathTufts University

Discussion

Member takes

Implication

May warrant closer CVD monitoring in anemic middle-aged adults; leaves open whether correction is causal or beneficial pending RCTs.

Key Points

To determine whether anemia is an independent risk factor for incident cardiovascular disease events in the general community population.
Analyzed 14,410 individuals (6,267 men and 8,143 women) aged 45–64 years without baseline cardiovascular disease from the Atherosclerosis Risk in Communities (ARIC) cohort.
Defined anemia as hemoglobin <13 g/dl in men and <12 g/dl in women, with outcomes tracked over an average follow-up of 6.1 years.
Used Cox proportional hazards regression to adjust for potential confounding covariates across the overall cohort and within sex and race subgroups.
Baseline anemia was identified in 4.8% of men (300/6,267) and 13.0% of women (1,058/8,143), with 549 total cardiovascular events (3.8%) occurring during follow-up.
The presence of anemia independently increased the risk of cardiovascular disease in the entire cohort (HR 1.41; 95% CI, 1.01 to 1.95).
Subgroup analyses across sex and race showed hazard ratios in the same harmful direction, though not all achieved statistical significance.

Study Design

Type

Cohort (n=14,410)

Multicenter

Yes

Structured PICO

Is the presence of anemia an independent risk factor for cardiovascular disease outcomes in the general population?

Population

14,410 adults aged 45 to 64 years without cardiovascular disease at baseline, followed for an average of 6.1 years.

Exposure

Presence of anemia (defined as hemoglobin <13 g/dl in men and <12 g/dl in women)

Comparator

Absence of anemia

Outcome

Cardiovascular disease (CVD) eventshard clinical

Main Result

Hazard Ratio: 1.41 (95% CI 1.01–1.95)

Anemia is an independent risk factor for cardiovascular disease outcomes in the general population aged 45 to 64 years.

Cite This Study

Sarnak et al. (2002) conducted a cohort in Cardiovascular disease (n=14,410). Anemia vs. No anemia was evaluated on Cardiovascular disease (CVD) events (HR 1.41, 95% CI 1.01-1.95). Anemia was independently associated with an increased risk of cardiovascular disease events (HR 1.41; 95% CI 1.01-1.95) in a community cohort of adults aged 45 to 64 years.

synapsesocial.com/papers/69ecdb66eb2c6328dba62cdb https://doi.org/10.1016/s0735-1097(02)01938-1

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Anemia as a risk factor for cardiovascular disease in the atherosclerosis risk in communities (aric) study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Anemia as a risk factor for cardiovascular disease in the atherosclerosis risk in communities (aric) study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider