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Increased serum ferritin is common in men with essential hypertension

Piperno, Albertoa; Trombini, Paolaa; Gelosa, Marisaa; Mauri, Vivianaa; Pecci, Valeriab; Vergani, Annaa,c; Salvioni, Alessandraa; Mariani, Raffaellaa; Mancia, Giuseppea,c

Original papers: Epidemiology

Objectives  Insulin-resistance-associated hepatic iron overload syndrome (IRHIO) is characterized by high serum ferritin and presence of metabolic alterations that are part of insulin-resistance syndrome (IRS). Thus, clinical conditions characterized by a high prevalence of IRS may also be characterized by a high prevalence of IRHIO.

Design and methods  We studied 88 consecutive patients with essential hypertension, 62 patients with IRHIO and 102 healthy normotensive controls. Hemochromatosis, other conditions able to induce secondary iron overload or serum ferritin increase unrelated to body iron stores were excluded. Iron indices, metabolic profiles and hepatic tests in hypertensive with or without increased serum ferritin and in IRHIO with and without hypertension were studied. Metabolic variables, serum iron indices, liver function tests and hepatic ultrasound data were analysed. Data were compared by non-parametric tests.

Results  In men with hypertension, increased serum ferritin was more frequent than in controls (21 versus 0%, P = 0.001). Hypertensive men with increased serum ferritin had more frequent and pronounced metabolic alterations than those with normal serum ferritin, the metabolic abnormalities and serum ferritin being frequently positively correlated. In hypertensive men with increased serum ferritin, metabolic and iron data were similar to those of IRHIO patients with hypertension.

Conclusions  In males, hypertension is characterized by a higher prevalence of increased iron stores and metabolic abnormalities that are part of the IRHIO syndrome. This finding may have clinical implications due to the increased risk of IRHIO patients to develop hepatic cirrhosis and also for the role of iron in early atherogenesis.

aClinica Medica, Azienda Ospedaliera S. Gerardo, Università Milano-Bicocca, Monza, bDivisione di Medicina II, Spedali Civili, Università di Brescia and cCentro Auxologico Italiano, Ospedale San Luca, Milano, Italy.

Correspondence and requests for reprints to Alberto Piperno, Clinica Medica, Ospedale S. Gerardo, Via Donizetti,106, 20052 Monza, Italy. Tel : + 39 039 2333079 ; fax: + 39 039 322274; e-mail:

Received 13 December 2001

Revised 27 March 2002

Accepted 5 April 2002

© 2002 Lippincott Williams & Wilkins, Inc.