From the Guidelines
Anaemia, particularly iron deficiency anaemia, can have significant negative health effects, including decreased quality of life, increased risk of hospitalization, and poor outcomes in patients with heart disease or inflammatory bowel diseases, as evidenced by studies such as 1 and 1.
Health Effects of Anaemia
The health effects of anaemia can be far-reaching, impacting both physical and mental well-being. Some key effects include:
- Decreased exercise capacity and poor quality of life, as noted in patients with heart disease 1
- Increased risk of hospitalization and death, particularly in patients with congestive heart failure or coronary heart disease 1
- Digestive issues, such as stomach pain, irritable bowel syndrome, and acid reflux, which can be triggered or worsened by anaemia, especially in patients with inflammatory bowel diseases 1
- Mental health impacts, including anxiety, depression, and reduced cognitive function, which can be associated with chronic anaemia
- Weakened immune system, making the body more susceptible to illness and infections
Diagnosis and Management
Diagnosing and managing anaemia effectively is crucial to mitigating its negative health effects, with a comprehensive approach including complete blood count, reticulocyte count, serum ferritin, and transferrin saturation, as recommended by studies such as 1. Key steps in diagnosis and management include:
- Complete blood count with mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) to identify anaemia and its type
- Reticulocyte count to assess bone marrow response
- Serum ferritin and transferrin saturation to evaluate iron stores
- Consideration of vitamin B12 and folic acid levels, especially in patients with macrocytosis
- Treatment tailored to the underlying cause of anaemia, which may include iron replacement, erythropoiesis-stimulating agents, or red blood cell transfusion, with caution against the use of erythropoiesis-stimulating agents in patients with mild to moderate anaemia and heart disease, as recommended by 1
From the Research
Health Effects of Anger
- Anger has been linked to cardiovascular diseases (CVD), with chronic feelings of anger, cynical distrust, and antagonistic behavior being at least modestly associated with the risk of both initiation and progression of CVD 2.
- The health effects of anger can be damaging, with anger/hostility also linked to stress exposure and reactivity, exaggerated autonomic function, reduced heart rate variability, platelet aggregation, and inflammation 2.
- Clinical and pharmacologic treatment of anger/hostility has the potential to reduce anger and its health-damaging effects 2.
Treatment Options for Anger and Anxiety
- Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are considered first-line treatments for childhood anxiety disorders, with the combination of CBT and SSRIs producing greater improvement than either treatment alone 3, 4.
- A network meta-analysis found that CBT, pharmacotherapy, and the combination of the two are effective treatments for childhood anxiety disorders, with no significant difference between the three treatment forms 4.
- Another study found that adding exposure and ritual prevention (EX/RP) to serotonin reuptake inhibitors (SRIs) was superior to risperidone and pill placebo in improving symptoms of obsessive-compulsive disorder (OCD) 5.
Comparative Effectiveness of Treatments
- A 3-level network meta-analysis found that all SSRIs and SNRIs were effective for multiple symptom domains, and in patients from all included diagnostic categories, with minimal differences between medications concerning efficacy and acceptability 6.
- The study also found that all medications were more effective than placebo for the aggregate measure of internalizing symptoms, for all symptom domains, and in patients from all diagnostic categories 6.