It might sound like something from the Middle Ages, conjuring up dark images for many of us, but blood-letting is now being considered as a potentially beneficial treatment for some heart disease patients.
Blood-letting was a medical practice that was used quite commonly during ancient times, in many different cultures, and right up to the 19th Century. Basically, it was thought that removing substantial quantities of blood from the body would prevent or cure many different conditions for a variety of reasons that we won’t go into right now. For the most part, this technique has died out, as it proved to be ineffective (and sometimes dangerous). However, it’s currently being investigated for a few diseases, including peripheral arterial disease (PAD).
Many medical professionals believe that there is a link between a high level of iron in the body and the risk of developing heart disease. However, this theory is controversial. It is thought that the body, unable to excrete iron (except in the case of premenopausal women), can build up the mineral to a point where it can cause oxidative damage. For this reason, it makes sense that bringing the level of iron in the body down could reduce a person’s vulnerability to heart problems.
That’s the reasoning behind this latest study, anyway. So, to see if there could be such a link, researchers decided to see if removing blood (thus, iron) could help people with PAD.
Peripheral vascular disease (PVD) can affect the veins, arteries, or lymph vessels. PAD is the most prevalent form of this disease — eight to 12 million Americans are living with it. What occurs is that fatty deposits (“plaque”) build up on the inner artery walls, slowing down and sometimes blocking blood flow. Eventually, such a blockage can lead to heart attack or stroke.
Another dangerous thing about this condition is that many people, especially women, don’t realize that they have it. One reason is that 75% of PAD sufferers have absolutely no symptoms at all. A second reason is the insidiousness of the most common symptom: cramping in the hips, thighs, or calves. This is caused by “intermittent claudication,” which basically means that, because the arteries are blocked by plaque, not enough blood is getting to your muscles, causing pain.
However, most people don’t pay much attention to cramps, leaving PAD to flourish untreated. If you’re feeling any type of pain in your leg area while moving, make sure you mention it to your doctor.
The recent PAD trial was based on within the Department of Veterans Affairs Cooperative Studies Program’s Iron and Atherosclerosis Study (FeAST), which occurred between 1999 and 2005. U.S. researchers performed a random study involving 1,277 adults with PAD. Half of the patients received blood-letting therapy, also known as “phlebotomy,” every six months. The other half was maintained as a control group.
At the end of the study, there was no significant difference between the groups when it came to mortality rate, either due to any cause or to heart attack/stroke. However, when looked at from an age standpoint, the numbers took on a different meaning. Study subjects between the ages of 43 and 61 who had had blood-letting saw some significant benefit.
Specifically, there were 54% fewer mortalities from all causes and 57% fewer after non-fatal heart attack or stroke in this group. Benefits were also seen in smokers and non- diabetics. Therefore, blood-letting could have a role in preventing heart-disease-related deaths — but only if it’s done early enough in life. More studies need to be done in order to back up these findings before blood-letting can be recommended as a prevention technique in PAD.