Schrage B, Rübsamen N, Ojeda FM, et al. - Findings imply that functional iron deficiency (FID) represents a relevant risk factor for cardiovascular (CV) diseases in the general population.

• This study included 12,164 individuals from three European population-based cohorts.

• Absolute iron deficiency (AID) was described as ferritin < 100 μg/L or as ferritin < 30 μg/L (severe AID), and FID was defined as ferritin < 100 μg/L or ferritin 100–299 μg/L and transferrin saturation < 20%.

• A high prevalence of FID was evident (64.3%).

• FID was related to incident coronary heart disease (CHD) [hazard ratio (HR) 1.24], CV mortality (HR 1.26), and all-cause mortality (HR 1.12), and had the highest population attributable fraction for these events.

• An association of AID with CHD (HR 1.20) but not with mortality was evident.

• Severe AID was only linked with all-cause death (HR 1.28).

• FID accounted for 5.4% of all deaths, 11.7% of all CV deaths, and 10.7% of CHD.