Abstract
Iron overload cardiomyopathy is becoming more prevalent, and early recognition and intervention may alter outcomes. Calcium channels are key transporters of iron under iron-overloaded conditions, and potentially represent a new therapeutic target for iron overload. The purpose of this study was to examine the relationship between Calcium channel blocker (CCB) use and serum ferritin among adults with diagnosed hypertension. We analyzed the nationally representative NHANES (National Health and Nutrition Examination Survey) 1999–2002 for adults ≥40 years with diagnosed hypertension. The association between CCBs and serum ferritin was assessed using a t-test and adjusted multiple regressions.The study population included 2143 individuals (representing 37.4 million individuals, 42.0 % males). 12.6 % of the population reported taking CCBs in the last month. Individuals taking CCBs had lower mean serum ferritin (129.3 ng/mL versus 154.5 ng/mL, p = 0.02). After adjusting for age, sex, menopause and hysterectomy status for women, race/ethnicity, and C-reactive protein, mean serum ferritin for individuals taking CCBs was 26.3 ng/mL lower than for those not taking CCBs (p = 0.01). In an adjusted regression, individuals who took CCBs and had a daily vitamin C intake of ≥500 mg had a mean serum ferritin that was 60.1 ng/mL lower than people not taking CCBs and with daily vitamin C < 500 mg (p < 0.001). In conclusion, this study found an association between use of CCBs and lower serum ferritin levels in individuals with hypertension. Further studies are needed to assess the possible use of CCBs as non-traditional chelating agents for treatment of iron overload cardiomyopathy.
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References
Addison GM, Beamish MR, Hales CN, Hodgkins M, Jacobs A, Llewellin P (1972) An immunoradiometric assay for ferritin in the serum of normal patients and patients with iron deficiency and iron overload. J Clin Pathol 25:326–329
Chaston TB, Richardson DR (2003) Iron chelators for the treatment of iron overload disease: relationship between structure, redox activity, and toxicity. Am J Hematol 73:200–210
Gujja P, Rosing DR, Tripodi DJ, Shizukuda Y (2010) Iron overload cardiomyopathy: better understanding of an increasing disorder. J Am Coll Cardiol 56:1001–1012
Ludwiczek S, Theurl I, Muckenthaler MU et al (2007) Ca2+ channel blockers reverse iron overload by a new mechanism via divalent metal transporter-1. Nat Med 13:448–454
Matheson EM, Mainous AG 3rd, Everett CJ, King DE (2011) Tea and coffee consumption and MRSA nasal carriage. Ann Fam Med 9:299–304
Miles L (1977) Measurement of serum ferritin by a 2-site immunoradiometric assay. In: Abraham G (ed) Handbook of radioimmunoassay. Marcel Dekker, New York, pp 131–177
Murphy CJ, Oudit GY (2010) Iron-overload cardiomyopathy: pathophysiology, diagnosis, and treatment. J Card Fail 16:888–900
National Center for Health Statistics, Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey. Data Sets and Related Documentation. Available at: http://www.cdc.gov/nchs/nhanes.htm. Accessed 10 Oct 2011
Nienhuis AW (1981) Vitamin C and iron. N Engl J Med 304:170–171
O’Brien RT (1974) Ascorbic acid enhancement of desferrioxamine-induced urinary iron excretion in thalassemia major. Ann NY Acad Sci 232:221–225
Otto-Duessel M, Brewer C, Wood JC (2011) Interdependence of cardiac iron and calcium in a murine model of iron overload. Transl Res. 157:92–99
Oudit GY, Sun H, Trivieri MG, Koch SE et al (2003) L-type Ca2+ channels provide a major pathway for iron entry into cardiomyocytes in iron-overload cardiomyopathy. Nat Med 9:1187–1194
Qaseem A, Aronson M, Fitterman N, Snow V, Weiss KB, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians (2005) Screening for hereditary hemochromatosis: a clinical practice guideline from the American College of Physicians. Ann Intern Med 143:517–521
Schmitt B, Golub RM, Green R (2005) Screening primary care patients for hereditary hemochromatosis with transferrin saturation and serum ferritin level: systematic review for the American College of Physicians. Ann Intern Med 143:522–536
U.S. Preventive Services Task Force. Screening for Hemochromatosis. August 2006. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspshemoch.htm. Accessed 10 Oct 2011
Weinberg ED (2006) Therapeutic potential of iron chelators in diseases associated with iron mismanagement. J Pharm Pharmacol 58:575–584
Weinberg ED (2010) The hazards of iron loading. Metallomics 2:732–740
Acknowledgments
Funded in part by cooperative agreement 1U01DD000754-01 from the Centers for Disease Control and Prevention. As a cooperative agreement, authors Mary M. Hulihan and Althea M. Grant from the Centers of Disease Control helped in all aspects of this study.
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Mainous III, A.G., Weinberg, E.D., Diaz, V.A. et al. Calcium channel blocker use and serum ferritin in adults with hypertension. Biometals 25, 563–568 (2012). https://doi.org/10.1007/s10534-012-9536-8
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DOI: https://doi.org/10.1007/s10534-012-9536-8