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While answering this question about the possible detrimental effects of iron deficiency caused by frequent blood donation, I was reminded of a theory I heard long ago about a possible benefit of mild iron deficiency for reducing cardiovascular disease. The theory goes that the lower incidence of cardiovascular disease in pre-menopausal women (vs men of a similar age) is due to mild, chronic iron deficiency induced by menstruation.

I found some old observational literature suggesting that there might be an association between blood donation and decreased incidence of cardiovascular disease. Somewhat more recently, a large retrospective study seemed to support this. However, neither is a controlled study, and I’ve not heard this possible benefit promulgated by the Red Cross or anyone else collecting blood.

Are there strong randomized data in support of the idea that regular blood donation reduces cardiovascular risk? Has the “optimal” hemoglobin concentration been determined?

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    A 2001 study says that there is no association. circ.ahajournals.org/content/103/1/52.full but here is a 1998 study that says yes aje.oxfordjournals.org/content/148/5/445.full.pdf
    – Rana Prathap
    Commented Apr 15, 2015 at 11:03
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    @RanaPrathap If you have an answer, please post it below. Comments were not designed to post answers and they do not have the features to vet the content properly. Thanks.
    – Robert Cartaino
    Commented Apr 15, 2015 at 14:08
  • Just a thought - Have you looked at, or are there any studies on the cardiovascular health of those that have hemochromatosis? That might help give an answer in inverse.
    – JohnP
    Commented Apr 28, 2015 at 0:56
  • @JohnP, yes a good thought and research has indeed been done on patients with hemochromatosis for this reason. I believe the studies generally tend to support the iron hypothesis.
    – Kenshin
    Commented Apr 28, 2015 at 17:05

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In premenopausal women, the risk of developing atherosclerosis is half that of men. In 1991, Sullivan proposed the iron hypothesis which attributed this decreased risk to premenopausal women's lower blood iron levels, and suggested that blood donation may reduce the risk of developing atherosclerosis.

The validity of the hypothesis is still an open question and presenting an analysis of current evidence would be long and inappropriate.

However honing in on the question of randomized clinical trials on the effects of blood donation, a first randomized clinical trial (FeAST) was conducted by Dr. Zacharski et al. in 2007, examining the effects of phlebotomy on the risk of cardiovascular disease in patients with peripheral arterial disease (PAD). The study found that a reduction in body iron stores did not significantly decrease all-cause mortality or death plus nonfatal myocardial infarction and stroke.

This FeAST trial has several limitations one primarily being that the trial focused on secondary prevention in patients who had existing PAD, rather than focusing on primary prevention as postulated by the iron hypothesis.

Therefore further research is still required before a conclusion can be reached on the validity of the iron hypothesis.

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    "...several limitations, one primarily being that the trial focused on secondary prevention in patients who had existing PAD..." This has been my problem as well. The studies are about the risks of anemia in people who already have cardiovascular disease of one kind or another.
    – anongoodnurse
    Commented Apr 28, 2015 at 4:50

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