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Haemoglobin concentration and the risk of death in older adults: differences by race/ethnicity in the NHANES III follow‐up
Author(s) -
Patel Kushang V.,
Longo Dan L.,
Ershler William B.,
Yu Binbing,
Semba Richard D.,
Ferrucci Luigi,
Guralnik Jack M.
Publication year - 2009
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2009.07659.x
Subject(s) - medicine , national health and nutrition examination survey , demography , confounding , ethnic group , race (biology) , mexican americans , gerontology , health and retirement study , non hispanic whites , population , environmental health , botany , sociology , anthropology , biology
Summary Mildly low haemoglobin concentration is associated with increased mortality in older adults. However, this relationship has not been well characterized in racial/ethnic minorities. Therefore, this study determined the haemoglobin threshold below which risk of death is significantly increased in older non‐Hispanic whites, non‐Hispanic blacks, and Mexican Americans. Data on 4089 participants of the 1988–94 US National Health and Nutrition Examination Survey who were ≥65 years of age were analyzed with mortality follow‐up through December 31, 2000. Mean haemoglobin in non‐Hispanic whites ( n = 2686) and Mexican Americans ( n = 663) was 140 g/l, while in non‐Hispanic blacks ( n = 740) the mean was 10 g/l lower. A total of 1944 (47·5%) participants died. Among non‐Hispanic whites and Mexican Americans, age‐ and sex‐adjusted models showed that the haemoglobin thresholds below which mortality risk was significantly increased were 4 and 2 g/l respectively, above the World Health Organization (WHO) cut‐off points for anaemia. In contrast, the threshold for non‐Hispanic blacks was 7 g/l below the WHO criteria. Similar threshold effects were observed when analyzing haemoglobin in categories and adjusting for multiple confounders. In conclusion, the haemoglobin threshold below which mortality rises significantly is a full g/dl lower in non‐Hispanic blacks than in non‐Hispanic whites and Mexican Americans.