Ongoing Controversies Surrounding the Vascular Benefits of Blood Donation

It was with interest that we read the article by Ascherio and colleagues1 on blood donation and risk of coronary heart disease in the Health Professionals Follow-up Study. The authors convincingly demonstrated that a lifetime history of blood donation is not a risk predictor of symptomatic coronary heart disease in men aged 46 to 81 years. Their conclusion, however, that these results conflict with the hypothesis that iron depletion offers protection against cardiovascular disease (iron hypothesis2–4) requires caution.The Health Professionals Follow-up Study was not primarily designed to analyze the effects of iron stores on vascular risk. The information on blood donation collected in this study was the overall (lifetime) frequency. According to the iron hypothesis, however, only subjects who regularly donated blood at the beginning of the study period (1992) or preferably throughout the entire follow-up period can be …