Chronic anemia and heart failure (2004 article) plus updates

J Nephrol 2004 Nov-Dec;17(6):749-61. Abstract placed here for convenience: 

 "Anemia is found in about one-third of all cases of congestive heart failure (CHF). The most likely common cause is chronic kidney insufficiency (CKI), which is present in about half of all CHF cases. The CKI is likely to be due to the renal vasoconstriction that often accompanies CHF and can cause long-standing renal ischemia. This reduces the amount of erythropoietin (EPO) produced in the kidney and leads to anemia. However, anemia can occur in CHF without CKI and is likely to be due to excessive cytokine production (for example, tumor necrosis factor-alfa (TNF-alfa) and interleukin-6 (IL-6)), which is common in CHF and can cause reduced EPO secretion, interference with EPO activity in the bone marrow and reduced iron supply to the bone marrow. The anemia itself can worsen cardiac function, both because it causes cardiac stress through tachycardia and increased stroke volume, and because it can cause a reduced renal blood flow and fluid retention, adding further stress to the heart. Long-standing anemia of any cause can cause left ventricular hypertrophy (LVH), which can lead to cardiac cell death through apoptosis and worsen the CHF. Therefore, a vicious circle is set up wherein CHF causes anemia, and the anemia causes more CHF and both damage the kidneys worsening the anemia and the CHF further. We have termed this vicious circle the cardio renal anemia (CRA) syndrome. Patients with CHF who are anemic are often resistant to all CHF medications resulting in being hospitalized repeatedly. Many studies also demonstrate that these patients die more rapidly than their non-anemic counterparts do. In addition, they have a more rapid deterioration in their renal function and can end up on dialysis. There is now evidence from both uncontrolled and controlled studies that early correction of the CHF anemia with subcutaneous EPO and intravenous (i.v.) iron improves shortness of breath and fatigue, cardiac function, renal function and exercise capability, dramatically reducing the need for hospitalization. For these reasons, it is not surprising that quality of life has also been shown to improve. As both CHF and end-stage renal disease (ESRD) are rapidly increasing, the possibility that these twin conditions can be improved by the adequate treatment of anemia offers new hope for slowing the progression of both conditions."


Updates on the Association Between Anemia and Heart Failure: A Systematic Review (2024)
Mirghani H, Alshareif A A, Al-Temani H A, et al. (September 10, 2024) Updates on the Association Between Anemia and Heart Failure: A Systematic Review. Cureus 16(9): e69101. doi:10.7759/cureus.69101

This is an open access cite--I'm not familiar with it.


Abstract of update: This systematic review aims to investigate the potential relationship between anemia and heart failure (HF) by summarizing existing literature on the topic. A comprehensive search was performed using four major databases, PubMed, Scopus, Web of Science, and ScienceDirect, to find the relevant literature. Ten studies, including a total of 2,828 participants, with 1,451 (51.3%) males, were included in this review. Iron deficiency anemia was the most prevalent type in the included studies; however, two studies included megaloblastic anemia. The prevalence of anemia in patients diagnosed with HF ranged from 33.3% to 69.8%, with a total prevalence of 1,643 (58.1%). Hypertension, diabetes mellitus, chronic kidney disease, and atrial fibrillation were the most commonly associated comorbidities in patients with HF. Anemia patients had a considerably higher risk of mortality than those without anemia. Anemia served as a marker of disease severity rather than an independent predictor of death in congestive individuals. Anemia was substantially correlated with elevated serum creatinine, left ventricular hypertrophy, and left atrial enlargement. According to the findings of this review, anemia has a significant impact on the prognosis of HF. In patients with HF, anemia may be a reliable indicator of both short- and long-term all-cause mortality as well as the rates of all-cause HF events. Future and ongoing research may provide vital information that may help guide clinical judgments in the future.


intravenous ferric carboxymaltose treatment

Intravenous ferric carboxymaltose for iron deficiency in heart failure patients: A meta-analysis with trial sequential analysis European Journal of Pharmacology, 5 December 2025 Laila Shalabi,Ahmed Ibrahim,Shrouk Ramadan,Sofian Zreigh,Shahed Shalabi,Mohamed Rifai,Abdelaziz A. Awad,Abdelrahman Mamdouh Ahmed,Matthieu Legrand,Dan Meyer,

Abstract
Background
Iron deficiency is present in roughly one-third to one-half of patients with chronic heart failure and is associated with worse outcomes. In this study, we aim to assess the impact of intravenous (IV) ferric carboxymaltose (FCM) administration on heart failure outcomes.

Methods
We performed a comprehensive literature search of PubMed, Scopus, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) up to May 2025. The outcomes of interest, including first heart failure hospitalization or cardiovascular death (primary outcome), total heart failure hospitalizations, and total all-cause hospitalization, were estimated using a fixed-effect model and reported as pooled risk ratios (RRs). Trial sequential analysis (TSA) was conducted to assess the robustness of the findings and estimate the required information size.

Results
Nine RCTs were included, comprising 7491 patients. Compared to placebo, FCM significantly reduced the risk of hospitalization due to heart failure or cardiovascular death (RR 0.89, 95 % CI 0.83–0.96; P = 0.0016). Additionally, FCM lowered the risk of heart failure hospitalizations (RR 0.82, 95 % CI 0.77–0.87; P < 0.0001) and decreased the risk of cardiovascular death (RR 0.89, 95 % CI 0.80–0.99; P = 0.0384). However, there was no significant difference in total all-cause hospitalization between the groups (RR 0.93, 95 % CI 0.85–1.01; P = 0.0830). TSA demonstrated conclusive evidence for the primary outcome.

Conclusion
FCM reduces the risk of heart failure hospitalizations, cardiovascular hospitalizations, and cardiovascular death in iron-deficient heart failure patients, although it does not impact all-cause hospitalization, thereby supporting its utility as a targeted therapeutic strategy.

PROSPERO ID
CRD420251062092.

To long to copy: Understanding Chronic Anemia, also known as Anemia of Chronic Disease or Chronic Iron Deficiency Anemia, is crucial for accurate clinical documentation and medical coding. https://s10.ai/diagnoses/letter-C/chronic_anemia

Who actually won? Not the Democrats.

People are saying the Republicans lost. If so then the "winners" in addition to being burdened with 40 years as anti-life baby killers, can now proudly carry the banner of anti-Semitic, anti-Israel, anti-science and anti-woman. In addition to the higher health care costs caused by Obama's policies 10 years ago, they now look forward to longer wait times at medical offices, assuming they can even find a doctor (except those removing non-diseased genitals in children). They don't even know what Communists did to agriculture in Russia and China.  They can return to being pro-fraud and don't even care if they are over-taxed so illegals can get rich and they can again feel self-righteous and virtuous to compensate for the self-loathing they feel for their race and ethnicity. They live in denial and are being held hostage by Islamofascists. They are completely ignorant about Communism and OK with shortages as their "leaders" live in the lap of luxury. They seem to love being called white supremacists and fascists and fight to move down on the ladder of excellence, preferring mediocrity and ignorant of history. Nope. They don't look like winners to me. Other than "get Trump" they haven't a single original thought, idea or value. They killed their own party.

Is this about war or affordability or Trump?

Obama was in a foreign war longer than any President in my lifetime. So why do Democrats, Communists and Islamo-fascists in the Democrat party and a large number of weak and uninformed Republicans and Independents think Trump is messing where he shouldn't be? 49 years those other presidents whined and shook a finger and rattled their cages at Iran and its proxies. So, what's the deal? Well, Trump is finally taking those men at their word.

First, they want to do away with Israel from the river to the sea, then western civilization. That means the USA. I hate all wars, whether all the civil wars in Africa that are racial, tribal and ethnic wars to Ukraine and Russia who are virtually the same family in language, religion, traditions and culture whose various monarchies and city states go back to the 800s AD. And even the culture wars going on in our communities and churches, and if we can't clean that up, whose wars should we be dabbling in?

Many voters (and non-voters who unfortunately have a big say in this) have a problem with Trump. Not war, not Gaza, not race. He is turning the post WWI power structure upside down. Who is pulling your strings and why do you think you will be better off under Communism? Surely not the strawman "affordability!" When has it ever improved the world, let alone people like you

Third quarter economy looks good today

The U.S. economy posted its strongest quarter in a year, with real GDP growing 3.4% annually in Q3 2026. In June 2014 Obama's Treasury Secretary said 2% was the "new normal." And with Obama, Biden and Islamofascists chanting free Palestine and stop the war on terrorists in charge of our economy we won't be able to expect growth.

Team Obama: Sorry, America, the 'new Normal' May Be Here to Stay | American Enterprise Institute - AEI

US GDP grew by 3.4 percent in third quarter amid AI investment boom

What is a banned book?

This is what Banned Books looks like folks: "Iranian author and filmmaker Majid Barzegar announced on his Instagram account that his two recent novels, both previously approved for publication and printed by Cheshmeh Publishing, have been seized and banned from further production and distribution." (Iran Wire)

Banning is not that silly self-serving advertisement from the American Library Association in October so a tax supported agency can make you afraid to speak up. ALA doesn't want you to criticize bad books and other media that libraries spend your money on

Amiodarone and the elderly, >75

Summary from 2019: Aust Prescr 2019 Oct 1;42(5):158–162. Amiodarone in the aged - PMC

Amiodarone in the aged

"Amiodarone is widely considered to be the most effective antiarrhythmic drug available.1 It is commonly used to treat atrial fibrillation and ventricular arrhythmias. Amiodarone, and its active metabolite desethylamiodarone, have multiple effects on cardiac depolarisation and repolarisation. Although it primarily blocks potassium channels, amiodarone potentiates its effect through all four of the classic Vaughan Williams mechanisms of antiarrhythmic action.

Despite its efficacy, amiodarone is a challenging drug to use in clinical practice due to its prolonged half-life, multiple adverse effects and drug interactions. These adverse effects are particularly problematic for older people who are more susceptible to drug toxicities and who have higher rates of polypharmacy. There is also a lack of information regarding the safety of amiodarone in older people.2 A cardiologist’s opinion is recommended before prescribing. 

[Unfortunately, it was prescribed by a cardiologist.]

Amiodarone can have adverse effects in multiple organ systems including the lungs, heart, liver, thyroid, gut, skin, nerves and eyes.3 Its use is also implicated in a range of drug–drug interactions with commonly prescribed cardiovascular drugs.4"

Also read from 2025: The Safety Profile of Amiodarone Among Older Adults (Age ≥75 Years): A Pharmacovigilance Study from the FDA Data. | Read by QxMD

CONCLUSIONS: In this global postmarketing study, interstitial lung disease and bradycardia were more frequently reported in older adults treated with amiodarone. These findings support vigilant monitoring for these adverse events, particularly in older patients.

In our case, there was "no vigilant monitoring."

Hot Showers and Syncope (fainting)--Risks and Triggers

How It Happens

• Vasodilation: Hot water causes blood vessels in your skin and extremities to widen.

• Blood Pooling: Standing up adds gravity, pulling blood into your lower legs. Combined with heat-induced vasodilation, more blood pools away from your core.

• Drop in Blood Pressure: Less blood returns to your heart and brain, causing a temporary drop in blood pressure and reduced cerebral blood flow, which triggers a faint.

Common Triggers & Risk Factors

• Dehydration: Low fluid volume makes blood pressure drops much more likely.

• Prolonged Standing: Locking your knees or standing still in a hot stall increases lower-limb blood pooling.

• Underlying Conditions: Arrhythmias, low blood pressure (hypotension), or certain medications (like diuretics or sedatives) raise your risk.

• Exertion or Post-Workout: Showering immediately after a heavy workout keeps blood vessels dilated longer.

• Underlying Conditions: Arrhythmias, low blood pressure (hypotension), or certain medications (like diuretics or sedatives) raise your risk.

• The Exertion or Post-Workout: Showering immediately after a workout keeps blood vessels dilated longer.

Prevention and Safety Tips

• Lower the Temperature: Use warm or lukewarm water instead of very hot water.

• Stay Hydrated: Drink a glass of water or an electrolyte drink before stepping in.

• Sit Down: Use a shower stool or chair if you are prone to dizziness.

• Keep Moving: Gently shift your weight and avoid locking your knees while standing.

• Cool Down: Finish your shower with a splash of cooler water.

Who is responsible, Biden or the church organizations?

Between January 1 and December 31, 2023, more than 520,000 people crossed the Darién Gap, nearly double the 248,000 who crossed in 2022 and more than triple the 133,000 who crossed in 2021. These were Biden's invaders, invited with promises of money and safety in sanctuary cities despite our laws. It's a horrible trek especially for women and children.

 
But they couldn't have made their way through that treacherous terrain without the help of Christian organizations many paid by our Protestant and Catholic bureaucracies. The organizations that helped them with food and shelter and even rape kits. 

Among Lutherans alone under the Biden administration, Lutheran Immigration and Refugee Service (now renamed Global Refuge) received over $881 million in U.S. government grants for migrant and refugee assistance, with annual amounts in FY 2021 and FY 2022 exceeding $93 million and $182 million respectively. Obviously not all that was spent in Panama or at our border, but that's a lot of salaries and support services and also the creation of small communities that never existed before. When bus loads disgorged in NYC or Washington DC you may have noticed from media coverage or TikTok reels how well dressed the invaders were--good shoes, clothing appropriate for the season, cell phones, etc. Your own congregations may not be as well fed and shod.

Shocking to me, and I asked Chat-gpt several ways, there is no record of or even if the individual congregations of Lutheran or Catholic of Baptists ever gave any money for these "good works."

https://www.doctorswithoutborders.org/latest/darien-gap-we-crossed-jungle-looking-better-future-not-our-lives-end

Bernie Sanders

If you ever thought one man or one vote couldn't make a difference, just think of Bernie Sanders. At one time he was the only "Democratic Socialist" in the Democrat Party--in fact, he didn't even call himself a Democrat, just said he was an Independent who ran for office of President as a Democrat. They really walked all over him and didn't accept him then--chose Obama and Hillary--but look at him now! He refers to the Democrat Party as "my party." It's now loaded with Communists and Islamo-Fascists. Biden led an army of 11 million invaders, and Hillary began stealing health care in Bill's first term, allowing AOC and Bernie to take up the call. While Bernie criticizes billionaires who have actually built something and provided jobs for you the people, he is a millionaire and laughs in your faces as you are blinded by an "affordability" crisis, the price of gasoline, so you ask/vote for more of what brought down Venezuela and Cuba. Yes, one man can make a difference,, and it will take a lot of votes to stop his global reach.

PolitiFact | What Bernie Sanders has said about the Democrats over the years

Transgressive poetry

Today I found a poetry term I didn't understand: "Transgressive poetry: Poetry that deliberately violates social, moral, or aesthetic norms; challenges taboos around language, body, or politics; associated with confessional and avant-garde movements." I suspect it must have been 20th century poets.

I tried to imagine what that would be in the 21st century when half the populace believes it's OK to kill preborn humans so the world could have more bats or jungles (but not more cows or cats); and calling a movie star fat when she is and moves to Ireland is equivalent to rape, but calling the President a Nazi or Fascist is just normal speech; or cutting off the breasts of young girls and loading them up with testosterone is compassionate care, but teaching them about Jesus would be violating her freedom and personhood.

The riots in France--not a student protest

My computer screen opened with the amazing Millau Viaduct in southern France built to relieve the tourist traffic in that scenic area and only recently surpassed by China as an engineering wonder. I wondered how it had survived the unrest. No mention. But that put me into the news at "France24." French media are just as naive and dumb as ours--still say it's a student protest. Dumb as U.S. Democrats.