People with anemia have an increased risk of heart failure. Moreover, having anemia can make for a worse outlook in people with heart failure. However, researchers do not know why this is the case. For now, there is no solid evidence that anemia can cause heart failure.

Anemia is when someone does not have enough healthy red blood cells. Heart failure is when the heart does not pump enough blood to meet the body’s demands.

This article explores both conditions and their relationship.

After discussing how anemia may affect heart failure and the outlook for those who have it, it details other cardiac consequences of anemia. The article also describes the symptoms, diagnosis, and treatment of both conditions.

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According to a 2021 paper, around 1 in 3 people with heart failure also have anemia.

The authors note that anemia and iron deficiency have associations with poorer outcomes in those with heart failure. Anemia can also aggravate symptoms of heart failure, such as shortness of breath and fatigue.

Experts do not understand why this is the case. It is not clear whether anemia can contribute to the development of heart failure.

However, having anemia may compromise the heart’s functioning in people with heart failure. This is because the heart needs a good supply of healthy red blood cells.

Heart failure is a serious condition. There is evidence that having anemia can make it worse.

In particular, a 2022 review estimates that for most people with heart failure, the risk of hospitalization and death is roughly 29.5%. The risk is around 47% in people who also have anemia.

A 2022 study explains there are associations between atrial fibrillation and anemia. Atrial fibrillation is when the upper chambers of the heart (atria) beat with an irregular rhythm.

The authors note that anemia may have an association with the development of atrial fibrillation.

Anemia can also lead to worse outcomes in those with atrial fibrillation and increase the risk of bleeding, cardiac events, and overall mortality compared with those with atrial fibrillation without anemia.

Research has also shown that anemia is a risk factor for the following conditions:

  • angina
  • heart attack
  • cardiac hypertrophy — when the muscle walls of the heart become too thick

According to a 2022 literature review, heart failure can present with the following symptoms:

  • chest pain
  • heart palpitations
  • shortness of breath
  • fatigue
  • anxiety
  • sweating
  • appetite loss

A 2022 paper details the symptoms of anemia. Some of these also arise in heart failure, such as fatigue, shortness of breath, and chest pain. Other symptoms include:

  • weakness
  • lethargy
  • restless legs
  • the desire to eat unusual foods or non-foods (pica)

Researchers have not tested specific guidelines for preventing heart failure in people with anemia.

However, research has shown that in the general population, several things may lower the risk of heart failure. These include:

  • achieving and maintaining a healthy BMI
  • not smoking
  • not drinking alcohol
  • getting regular exercise

The following diagnostic tests can help doctors spot heart failure:

  • echocardiogram, which shows images of the heart and circulatory system
  • other imaging tests, such as chest X-rays, CT scans, and MRI scans
  • blood tests to check levels of molecules in the blood, such as a brain natriuretic peptide test
  • blood pressure tests
  • electrocardiogram, which records the heart’s electrical activity
  • a stress test, which measures how the heart works during exercise

These procedures differ from the tests for anemia. Anemia diagnoses focus on using various blood tests. These can help to narrow down anemia sub-types.

The main treatment options for heart failure include:

  • healthy lifestyle habits
  • medications for heart failure, such as beta-blockers, diuretics, or angiotensin-2 receptor blockers
  • devices to control heart rhythm, such as pacemakers
  • cardiac surgery
  • heart transplant

For anemia, the treatment options depend on the underlying cause. A doctor may suggest:

  • oxygen therapy and blood products for anemia resulting from acute blood loss
  • iron supplementation for anemia due to iron deficiency
  • bone marrow transplantation for anemia due to bone marrow or stem cell problems

There is no evidence that curing anemia can help with heart failure.

Having anemia is a risk factor for several cardiovascular problems, such as atrial fibrillation, angina, and heart attack. It is also a risk factor for heart failure.

In people with heart failure and anemia, there is an increased risk of serious complications. However, researchers still do not understand why this is the case.

Regular exercise, losing overweight, and avoiding smoking and alcohol can all help in preventing heart failure.