Haemoglobin concentration and the risk of death in older adults: Differences by race/ethnicity in the NHANES III follow-up

Kushang V. Patel, Dan L. Longo, William B. Ershler, Binbing Yu, Richard D. Semba, Luigi Ferrucci, Jack M. Guralnik

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)514-523
Number of pages10
JournalBritish journal of haematology
Volume145
Issue number4
DOIs
StatePublished - May 2009

Keywords

  • Ageing
  • Anaemia
  • Haemoglobin concentration
  • National Health and Nutrition Examination Survey
  • Race/ethnicity

ASJC Scopus subject areas

  • Hematology

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