Iron Deficiency Anemia Linked to Higher Stroke Risk in Young Adults: Study

While the association between IDA and stroke has been previously recognized in children, data on its impact on young adults have remained limited. To address this gap, Jahnavi Gollamudi and colleagues conducted a large-scale retrospective study using a comprehensive health service database, evaluating over 21.8 million individuals aged 15 to 49.

The following were the key findings of the study:

• A total of 36,989 individuals in the study had experienced a first-time ischemic stroke.
• Among stroke patients, 5.1% had a prior diagnosis of iron deficiency anemia (IDA), compared to only 1.1% in those without stroke—a fivefold increase in prevalence.
• IDA remained an independent predictor of stroke risk even after adjusting for conventional risk factors like hypertension, diabetes, dyslipidemia, smoking, and obesity.
• Many young adults who suffered strokes lacked typical atherosclerotic risk factors, suggesting IDA acts as a standalone contributor.
• Untreated IDA, known for symptoms such as fatigue, dizziness, and poor concentration, has also been associated with an increased risk of thrombosis.
• This study is one of the first large-scale efforts to quantify the link between IDA and ischemic stroke in young adults.
• IDA may contribute to a prothrombotic state through mechanisms such as increased endothelial P-selectin expression, decreased red blood cell deformability, and suppression of Kruppel-like factor-2 (KLF-2).
• These changes create conditions that favor both venous and arterial clot formation.
• The study identified demographic differences, showing that African American adults aged 20–39 with IDA were at a higher risk of stroke than older Caucasian adults with the same condition.
• The disparity may reflect differences in access to healthcare, nutritional status, and timely diagnosis.

Despite its strengths, particularly the use of real-world data from a vast population base, the study also acknowledged limitations. The retrospective design, potential underreporting of IDA, and the inability to evaluate socioeconomic or inflammatory factors may have influenced the findings. Moreover, the study did not explore the impact of latent iron deficiency (without anemia) or post-stroke outcomes.

The study reinforces that IDA, a common yet often overlooked condition, poses a significant risk for serious complications like stroke, even in young, otherwise healthy adults. The authors call for proactive screening and management strategies to mitigate this risk and reduce the burden of stroke in this vulnerable population.

Reference:

Gollamudi, J., Al-Kindi, S., & Nayak, L. (2025). Iron Deficiency Anemia and Ischemic Stroke in Young Adults. EJHaem, 6(2), e70008. https://doi.org/10.1002/jha2.70008